It's over

It is with a heavy heart that I report that my precious baby Jake passed away on Tuesday Dec 18. He became weak over the weekend and by Monday was vomiting, unable to stand or hold up his head.  His doctors think he had a reaction to the Chemotherapy, but we cannot be 100% sure. He went into respiratory arrest and  did put up one hell of a fight, but the cancer won the battle.  The cyberknife treatment gave us an additional nine months with him and I would not have traded one second of the time.   We hope our posts here will give encouragement and support to other families who face this type of cancer as well as information on making decisions about treatment for your beloved fur baby.

7 months post cancer diagnosis- Doing great!

JAKE'S DOING GREAT!!!

We went away for our honeymoon and Jake was home for 2 weeks without us. His "nanny gail" came to the house several times a day, walked, fed and played with him and he did great!!! We had been so afraid to leave his side- which we haven't done since his cancer diagnosis 7 months ago.

Remarkably we're still seeing improvements - his gait his more steady, eating great, wants to be with us all the time (when he doesn't feel well he would "sulk" in the hallway by himself) and he's taking longer and longer walks now!

He is ready for his 6 month post cyberknife MRI scan to recheck the tumor size and check on his progress. We'll schedule it this week and are eager to find out if the test confirms what we already suspect- that nasty tumor must have shrunk or, as the dr described may be the case, the tumor may have become 'deactivated' by the radiation so its no longer growing or causing the brain to swell. We are beyond happy with the result since cyberknife.

7 months ago my baby dog was lifeless laying flat and couldn't get up. I have had all this extra time with him an it is filled with an awesome quality of life for Jake (and us). Proof of how good he is feeling is last night he made 20 (yes that's T-W-E-N-T-Y) laps around the dining room table during dinner. It was always his habit to make circles around the dining room table to show he was excited about what food was on the table that night for dinner (especially on steak nights!) but I NEVER remember him doing this many laps. He had just taken a good long walk and then ate dinner and then started circling our table hoping for table scraps. Completely amazing! He's not only holding his own - he's still improving little by little.

Will post pix again soon. Big paws up to all Jake's followers. We hope your doggies are doing well too :)

Still doing good!!

Some of Jake's loyal blog friends asked how Jake is doing so we're posting a quick update. He is doing great!!!! He is eating well, taking his walks (slow but consistently getting good exercise) and happily engaged and interested in being with us. He is back to barking at "possible intruders" outside the house and all the animals he sees on tv. His ears are on high alert whenever he sees a bunny in the yard. And he puts on his sweetest begging face everyday sitting next to the dinner table eagerly waiting for a snack to fall his way.

Yesterday we went for a car ride to carvel to get his favorite ice cream and he was in heaven. Yesterday he also got excited when I came home from work and went right over to his tennis ball to ask for play. His personality, though less enthusiastic than before, is still there. He lays on my lap, gives kisses, and "purs" when you pet him. He's happy and we love every minute with him.

We haven't started chemo yet because we need to wait until we are back from our delayed honeymoon. We'll have to watch him carefully during that time and can't risk doing it while away.   He is down to 1/2 a dexamethasone pill daily and we don't intend to lower it any more since he truly seems to need it and it is a small dose. Our strategy that's working thus far is keeping him eating, drinking and going for walks to pee frequently so he doesn't get a UTI again. At the times of the day he has the most energy we take longer walks to help keep his strength up. He still doesn't walk up stairs (although he does this randomly when he feels up to it) but otherwise walks around fine. We lovingly call him "wiggle butt" because he his back end seems to drift as if he needs an alignment still but he makes it work. He has learned to compensate for whatever that tumor is doing to his balance. He is superdoggy after all.

Will post updated pix soon. Best to all fur friends, those present and gone to doggy heaven (RIP Roxy).

Jake is 10 and doing great!

Jake turned 10 years old and is doing great !!!

On July 8 Jake turned 10 years old and his birthday was even more meaningful than ever this year. It's now been five months since he got sick and three and a half months since he had cyberknife radiation. It's been a rough road but Jake is still smiling and happy and we cannot be more grateful.

He has resumed some interest in playing with his toys and is extremely engaged with us and happy to be 'part of the pack' everyday. He's had some setbacks with urinary accidents as we taper his steroid dose down but generally tolerating it really well. He's now taking .25mg of dexamethasone daily down from needing 1mg daily.

Next stop chemo...... Will update more soon.

Our bestest man at our wedding yesterday- Jake- our Superdoggy

Haven't posted in so long because I was planning my wedding, which was yesterday and it was GREAT! The best news is Jake is doing well and he made it to the wedding and was able to be one of the groomsmen (see above). When we first set our wedding date and then found out Jake's diagnosis we wondered if he would make it. We're SO grateful he is OK and was able to be part of our most special day.

To recap the past month:

Steroid taper:  Memorial Day weekend we attempted to taper again and he reacted the same way, had a really hard time getting up, started throwing up and having urinary accidents in the house. Dr Joseph put him on an antibiotic (even tho bloodwork showed no issues), reverted back up on his steroid dose and he was good as new! With the wedding coming we didn't want to risk him taking a downturn so we didn't initiate another taper but will starting tomorrow. This time we will not let him skip a day of steroid and will try going from 1 full pill, 1/2 pill, 1 pill, 1/2 pill.... to 1/2 pill, 1/2 pill, 1/2 pill, 1 pill and then repeat. We've learned how senisitive he is and that skipping a day of meds is torture for him. A slower taper is better than no taper.

Other updates: The gag/cough thing he was doing is only 1-2 times per day now (best ever), he's willing to go on longer walks but is still slow. He's wagging his tail a lot showing he's happy and wants to spend more time bein in the middle of the family action again rather than going off in the hallway by himself. When family comes over he greets them and wags his tail. He now even barks at the tv again when animals are on- I think either his vision has improved or he is less dizzy so he's able to see the tv more clearly again. He walks more straight, leans on the wall less often but his back end does still drift at times. He's able to stand stronger and pee without us holding him so he doesn't fall over.

Back legs: Jake still doesn't seem to have proper strength or control over his back legs. He won't go up stairs but there are times when he tries. He has started to put his front paws up on the 1st step of the staircase but then stops. A few times I've been able to encourage him strongly to try and he goes up a few steps but seems to be dragging his undercarriage. However 2 days ago he came back from the groomer and was strong enough to walk up 2 flights of stairs completely by himself- totally weird and don't know why. Another reason we know there's a problem with his back legs is because he used to do agility and could jump up very high and he would jump up during dinner time to ask for his carrots. Now he tries to jump but can only lift his front legs and his back legs stay firmly planted on the ground like they're glued down- very weird.

Overall, Jake is a blessing and we are grateful for every moment we have with him. As long as he continues to have more days than not when he's wagging his tail, smiling, happy to see us and eating and drinking well it is a great day!

Jake continues to have good days and bad days.  He will have 3 good days, then a bad day.  A good day is one where he doesn't lean, barks a lot (duh, he's a Sheltie) and wants to go out for a walk. A bad day is one where he leans, looses his balance, vomits, spins in circles, moans in pain and eats very little. He is moving slower than he did before CK, but there is improvement.  He is still on Dexamethasone (steroid) on a tapering dose.  His next step is starting chemo.  We need to make sure he is not vomiting or having diarrhea.  He still has his wonderful personality and still makes me smile everyday.

1st post- cyberknife follow up doctor visit

Driving to 1st follow up

1st follow up done! Jake had his first follow up visit with Dr Joseph this week and the dr was pleased to see his progress. Even though he still leans and is much slower than his normal self he is making good strides. Jake was a trooper, glad he wasn't poked as much as last time but was sad he missed seeing his nurse Emily (her day off).

Not feeling well. The morning we were set to go to the dr follow up Jake got sick in the middle of the night.Truthfully it's unclear if he threw up or had diarrhea because it was hard to tell what we found. If that's the case then this would be the first time ever that he went to the bathroom in the house. Also, he peed in the house first thing in the morning just as we were about to take him outside (He's done this 1 or 2 times since he first got sick but these are the first times in his life he's ever had accidents in the house). Then to cap things off he threw up in the drs office that morning. Not sure what this was all about but he definitely didn't feel too good.

What to expect. The dr wasn't overly concerned about this all and said he will have good days and bad days. He took a blood and urine test to check for infection just to be safe. He says the goal now is to let the steroids buy us time while we wait for the full effects of the cyberknife treatment to set in (which could be several months). We tried lowering his steroid (dexamethasone) to 1 pill per day and he started leaning much more and was having a hard time so the dr said we should give him 2 pills one day and 1 pill the next and then in 2 weeks try to re evaluate. The goal is to get him to the lowest possible dose of steroids.I wish steroids had no negative long term consequences because he is so much better on them and wish he could stay on them forever.

Chemo Discussion. We were supposed to start him on chemo at this visit (hydroxyurea) but considering the diarrhea, throwing up, etc Dr J says we should wait a week and then start him. We're concerned about the potential side effects of chemo but we understand from our reading that dogs handle it much better than humans and if all goes as expected he should take it and not feel sick. More to come on this when we start.....

Had to mention this. We're pleased to say Jake is back to some of his old tricks. Jake always used to place himself right in from of the tv staring at us as if to say "hello don't ignore me, stop looking at the tv and look at me!!" He's still the same old Jake :)

10 days post cyberknife- Still doing good!

Just a quick post to say it's three days in a row now that Jake is doing good. Tonight he came up and put his little face on the couch when he saw I had ice cream and stared up at me like he used to saying "I'm cute, please give me ice cream". Had to take this pic of him being so cute. He still so alert and becoming more like his usual adorable self. :)

Jake's eye, energy and cough

For the last 2 days Jake is obviously feeling good.The littlest things are so important to us now. He's been laying in the hallway less and wanting to be with us more (and under our feet more like he used to always be). His energy is great. He has been walking so much slower than before this all started but today he walked out ahead of me and actually led the way like he used to!

His right eye also seems to be drifting less. Not sure if we mentioned it before but his right eye used to drift a little when he was really tired. Since the treatment we noticed his eye was always drifting and seemed almost 'vacant' compared to his other eye. Looking at him with his eyes so clear again is such a great thing!

He still has his cough/gag that he's had since he first got sick. It's upsetting to hear. I don't know if this is something that other dogs with brain tumors have so in case it helps anyone I'm going to upload a video of him doing this so you can compare to your dog. He does it whenever he eats or drinks.

For the whole week since radiation ended he's seems to have one good day then a bad day and the cycle continued. We got 2 days back to back this weekend so we're thrilled and hope things continue this way :)

6 days post cyberknife

Jake is now 6 days post cyberknife. I see he's been reporting how he feels himself  but I want to weigh in on how he's doing too. We're starting to be concerned that the tumor is still active. He's able to walk straight but is still leaning to the left and voraciously hungry- which could be the tumor or the steroids. He is also moaning every time he lays down as if to say "ugh.....i am so sick of this and just want to get comfortable and can't". I'm not sure if it's because he's in pain.

Also at times his limbs (especially the front left paw) gets stiff and crooked and he can't seem to straighten it out. We massage him and it seems to help but this was happening just before radiation when he was at his worse so we're not happy to see this happening again. Strangely this only seems to happen when he's very tired at the beginning or end of the day.

His personality is still not quite the same as before. He wants to be off by himself laying in the hallway alone a lot. I don't know if he's tired, in pain, etc. This might not seem like a big thing but his personality before was that he was literally involved in every single conversation and activities we did in the house. He was never one of those dogs who just sat by himself. He was always the center of the house. It's weird to say but even though he's here we still miss him.

Feelin' Great !!!!

day after radiation ended

Mommy left herself logged into the computer and I'm taking over! It's me, Jake! I want to tell everyone how I've been feeling since radiation ended last week in my own words!

This has been a completely bizarre experience. Today I felt good and jumped off the bed, lunged and barked at the tv and scarfed down a rogue munchkin  I found on the floor- ALL of which normally would have made mommy mad at me but instead when I do these things now I get hugs and a "Good boy". What is going on ????

I feel strong, I'm wondering why everyone is fussing over me. It's total MOTHER SMOTHER.  I want to go outside and run but I seem to get tired faster than normal when we go for walks. Other than that I am great!!! I'm planning to keep up this blog myself from now on. I can handle writing about my experiences.  

I made a friend who also had cyberknife radiation and he wrote about us meeting on his blog. Check him out at: http://maxck.blogspot.com/

Uh oh, mommy's coming. gotta go, will write more later :)

Day 3 - Radiation done !!!!

Jake in recovery room after last treatment

Jake finished his cyberknife radiation treatments today!!! We were prepared that with the anesthesia three days in a row he might be worn down and not respond well but instead he actually got better each day!! He walked out of the clinic just like yesterday, straight as an arrow instead of his usual head tilt and leaning to the left. He was even excited at the site of his favorite tennis ball again. It is nothing short of a miracle!!! We think he may have sent that tumor packing!

Just like with humans, animals also deserve dignity during their illness and treatment. I have to say that before treatment Jake was starting to lose his dignity and quality of life. He was tired all the time, stumbling around the house and couldn't take walks and play. He couldn't even go to the bathroom without leaning on the wall outside the house or us holding him to prevent him from falling over. Jake was too dignified to live like that. I am SO grateful that we found a treatment that was non invasive and able to help give us all more time. He has given so much to us over the years and he deserves every available option.

Another paws up to our AMAZING treatment team at the Animal Specialty Center in Yonkers. We know that it wasn't just the treatment or the medicines that made him better but the entire setup and how they take care of the animals, minimizing their anxiety (and the owners) and showing care and concern every step of the way. Dogs like mine who are a very sensitive and smart breed can feel this from the staff in all of their interactions. I know it may seem like a cliche but every day truly is a gift. Without this treatment we would have lost Jake weeks ago and this has given us all more time- bonus time we never would have had otherwise.

Jake has made a furever friend in his nurse Emily- see below. Emily and Dr Joseph were so invested in Jake's treatment and were so genuinely concerned for him- we cannot thank them enough and consider them our angels.

Day 2 done, doing great!!!

Day 2 of 3 cyberknife radiation treatments done!! I have no idea why Jake did so well today but after today's treatment he was able to walk straight (without leaning to the left) for the first time since this whole thing started. He literally moonwalked right out of that clinic today!!!

This treatment is not at all supposed to work this quickly -its really the combination of steroids they're giving him that's working miracles right now but we'll take it!!  Today's recovery was so great, he was resting and glassy eyed but then after an hour we said "wanna go for a ride?" and he popped up and started walking !! He wanted to go home :)


We really cannot say enough about the staff at the Yonkers animal specialty center - they have been so amazing. They have really gotten to know Jake and learned what he needs to be comfortable- from what combo of meds work best for him right down to the littlest details of how he likes to be covered with his blankie and positioned comfortably during and after his treatments.

I feel like our tech Emily has become one of the pack family. Jake - a very reserved sheltie who doesn't give hugs and kisses until he really knows you - actually went over to her and leaned into her to say goodbye today (his version of a hug). He knows he's well cared for and feels safe there. Who could ask for anything more?

Emily took this cute picture of Jake when he first came into recovery.

 

DAY 3 HERE WE COME!!!!

Other cyberknife doggies on this site

We cyberknife doggies have to stick together. Jake says read my friend's blogs (Max and Roxy) at:
http://maxck.blogspot.com/
and
http://roxycyberknifebraintumor.blogspot.com/


Paws up!

Day 2 going well

Jake writing his blog

Jake's in having his second cyberknife now. We're hoping the next two will go just as well as the first. He seems like his happy sweet self.  The doctors informed us that each consecutive day of anesthesia increases the overall mortality risk.

I am staying positive. I am still on a roller coaster.  I go from profound sadness to acceptance back to sadness. I also have been spending way more time with him, doing fun things or just hanging out together. No matter what, I have no regrets. Feeling the need to share pix of happier times.

I love the snow!!!!

Day 1 done, Doing well !!

Jake is alert and happy even though he knew he was going to the dr for his first treatment today (see car ride photo above). He didn't even give me a hard time when I couldn't feed him in the morning - I told him the dr said no food before your appt today and he seemed to totally understand. He is such a trooper. If this were me I'd say screw it I'm gonna eat ice cream and chocolate 24/7 and no one would be able to stop me.

We were so nervous about today's first radiation treatment that we messed up the time were supposed to arrive :(  We were so happy that they let us sit with him during his pre treatment medication time and immediately after coming out of the rad treatment we were able to sit with him through recovery! None of us were happy we had to be going through this but so relieved we could all be together throughout it. :)

No bad reactions to the anesthesia this time and we were able to be home by 2pm and he was able to rest. He has his little iv port in for the 3 days of treatment and we have to flush it every 6 hours. Apparently he has bad veins (who knew?) and it's better to keep it in rather than stick him 3 separate times. I don't mind, the littlest things that we can do for him now mean so much more.

He's home resting, looks great so far! 1 down, 2 more to go !!

jake getting pre treatment meds on radiation day 1

Pre treatment, Day 0

In order to start cyberknife there is an intense day of pre planning the week before where they do a ct scan, MRI, implanting of gold seeds in the roof of your dog's mouth that will help guide the laser to the exact location of the tumor, and an ultrasound (to rule out cancer in other areas of the body- if cancer has spread its unlikely you'll be proceeding with radiation). It all requires anesthesia so on Jake's pre planning day he was under for quite a while and did not feel very good when he got home (see above). He wanted to lay flat and not get up.

We hadn't thought this would be a big treatment day so we didn't schedule time off work to stay with him and we at the last minute had to make an unscheduled visit to our regular vet to get iv fluids and medicine. With this type of tumor (and having anesthesia) the brain swells and in his case he became disoriented and needed a diuretic medicine to take the swelling down. 1 ER visit to the vet and he again rebounded and was good as new. He's got a lot of fight in him yet!!

His leaning is still bad and we have to counterweight him by pulling on his harness (in the opposite direction of his body lean) when goes to the bathroom so he doesn't fall over. He still doesn't bark quite right. Forgot to mention but this was one of the early signs we noticed before we knew it was a brain tumor. When he barks he sounds like a dog that has been debarked for some reason. He also stumbles around the house - in fact the internet refers to this as 'drunk walking'. We've had to make the whole house disability accessible for now because he trips over everything and needs the perimeter of the house clear of furniture and objects- to balance himself he leans his left side on the walls.  There are now rugs everywhere so he doesn't have to struggle trying to walk on slippery tile or hardwood- which is usually 95% of our house. But for a dog with a brain tumor this is all relatively good- he's doing well; eating, drinking a lot (still on steroids so they eat, drink and pee a lot!).

We got our clearance to start our radiation treatments starting next week!!

Specialists

We should say, our inspiration for this blog came from finding "Max the cyberknife dog"- a blog on this site. It gave us hope when we thought there was no one else going through this. Jake was going to be a therapy dog, maybe through this blog he'll be able to bring a different type of help to people and their dogs at the same time......

With a brain tumor time is of the essence. He was going downhill fast and we needed to decide what we would do. Within a week's time of Jake's diagnosis we investigated all our options and find amazing resources so we thought we'd share the story of how we chose his treatment.



Maybe we should drive to Minnesota for a clinical trial???

We're researchers at heart (and profession) so we scoured the internet and come across a dog clinical trial for the exact type of tumor Jake has being done by Dr. Liz Pluhar in Minnesota (http://www.cvm.umn.edu/newsarchives/2009/BrainTumorClinicalTrials/home.html). She actually calls us back personally the same day I leave a message, agrees to review his scans and get back to us which she does in no time. She is the kindest, most knowledgeable and honest dr I've ever spoken to!!!

We speak about the potential benefits, risks and also the challenge of driving him to Minnesota 20 hours away. She's honest about the success rate of prior cases exactly like Jakes and we decide collaboratively its not the best choice for him. Her work is amazing and I vow to myself that I will 'like' her facebook page, scream from the rooftops, do whatever I can in the future to let more people know about the work she's doing. She gives options to people and their dogs who have no other options in the world- and with kindness and compassion rarely seen by drs of any kind. AND, she takes the time to conduct actual research just like human randomized clinical trials that make head to head comparisons of different treatment regimens to advance vet medicine and give us real data to guide treatment options. Rarely do vets ever conduct clinical trials so her work is a HUGE benefit to the field and will undoubtedly help improve treatment options for many dogs in the future. A big paw's up for Dr. Pluhar !!

The Animal Cancer Foundation is giving a lecture on new treatments in canine oncology the week we find out about Jake's tumor- maybe it's a sign!
We knew NOTHING about cancer except for the human experience of misery and harsh treatment side effects. The week of Jake's diagnosis we find out Dr Gerald Post, a vet oncologist and Founder of the Animal Cancer Foundation (http://www.oncovet.com/about) has decided to move his vet specialty practice to Newtown, CT about 10 miles from me! He's holding a cancer talk in my town and I decide to go and see what I can learn. This was a hugely important step in deciding what treatment we would pursue because his talk was about the myths and realities of canine cancer treatment. Most importantly it taught me that cancer treatment is NOT the same in animals as it is for humans. The side effects are so much more minimal and in fact he showed pictures of a dog he treated who actually won agility trial championships while taking chemotherapy meds!

When you get a cancer diagnosis its natural to think "Do i really want to put my dog through that?" "Is my dog going to be throwing up and having diarrhea, burned from radiation and miserable for his last days?" Dr Post's talk was enlightening and so relieving to hear. It wasn't a choice we had to make out of fear of side effects, we could move forward just considering what is the best treatment for the type of cancer he has. Huge relief. Dr. Post - another paw's up!

Maybe we should go with Cyberknife radiation treatment at the Animal Specialty Center in Yonkers, NY .

We learn from our local vet that we happen to live within 1 hour of one of the best vet specialty centers (Animal Specialty Center - Yonkers, NY); http://www.vcaspecialtyvets.com/animal-specialty-center). They have specialists of all kinds- neurologist, oncologists, dermatologists, dentists, physical therapists, etc all under one roof. We visit with their neurologist Dr. Joseph and within seconds he tells us he knows its a brain tumor, later confirmed by MRI (see picture, top left base of brain). The tumor is large and in the base of the brain - the area responsible for breathing and all basic life functions so surgery is NOT an option.

We hear from Dr Joseph that if Jake gets strong enough and responds well to steroids we can schedule him for cyberknife radiation- a special type of radiation that was pioneered at this center and is the only machine in the world (yea, that's right.........not country, but world that has it). Now, let me tell you, this is some high tech stuff. From what I understand, regular radiation requires 15-20 treatments with anesthesia EVERY treatment and can leave your dog sick and with radiation burns, etc. The cyberknife radiosurgery uses a high tech robotic arm to deliver laser like precision doses to the exact location of the tumor and treats the tumor in 1-3 treatments. This is a HUGE improvement, more efficient and precise.


So, we're told there's only about 400 dogs who have had this treatment before in the last 2-3 years and no published data is yet available. These are the facts we're also faced with: Dogs who do not get treated for meningiomas have about 2 months to live,dogs with cyberknife can get 1 to 1 1/2 years if all goes well and you follow up with chemotherapy. For us it was a no brainer (poorly timed pun I know). We schedule the cyberknife to start on April 18 for 3 consecutive days.We go on a tour to see the robot that will be delivering the radiation - I affectionately call it "Johnny Five" from the 80s movie Short Circuit.

After reviewing many excellent options and finding many kind and knowledgeable people along the way to help us we've decided on our treatment. Johnny Five here we come!!!!

Jake's MRI

Disclaimer- I am a distraught owner of a dog with cancer and although I pride myself on being smart, I'm at about half strength right now with the emotional roller coaster of this all so I may not be fully explaining cyberknife treatment in the best detail. For full, accurate medical info see: http://www.vcaspecialtyvets.com/animal-specialty-center/departments-doctors/departments/radiation-oncology

cyberknife machine, AKA "Johnny Five"