REMY diagnosed last week

[Remy’s Mom]

I thought I had a reply ready to send but it disappeared. SO…..oncology visit went as expected. Did not see attending clinician, an intern doing internal med/oncology rotation saw us. Remy was anxiety ridden but cooperative. For now we will treat with Meloxicam and monitor blood work and the mass via ultrasound every two weeks. If we see progression of the cancer then we will have to make some decisions about further treatment. I see such interesting alternative treatments such as immunotherapy but they are not available here in the US or they require a sample of the tumor which is very risky for bladder cancer due to the danger of seeding. So between the diabetes, Cushings, and now bladder cancer I have my hands full. BUT Remy seems happy and his quality of life is good so that’s the main thing!!

[Harley PoMMom]

Claire,

You're doing such a wonderful job with Remy, he is a lucky boy to have you as his Mom!! Sending you both huge and loving hugs!!!

[Remy’s Mom]

Thank you so much for the encouragement.I look at it him and he’s such a happy boy and I don’t know how much to put him through. Most dogs adapt well to the chemotherapy protocol but Remy is such a strange little guy I just can’t see him being OK with it. I pretty much have to opt for something we can give orally at home. I think I could manage the Cushings and diabetes but bladder cancer is another story. I’ve been trying to avoid the ‘sad’ moments that can be overwhelming at times. He feels good as far as I can tell and he’s happy and given his age that’s something to be thankful for!

[Remy’s Mom]

REMY UPDATE. I had Remy in for lab work, urinalysis and an ultrasound to see how his bladder tumor looked. So far so good, it has not changed. His liver values were quite a bit higher on the Meloxicam. I had had the DVM do a baseline cortisol and it was 7.1 so a little higher but not bad. No symptoms of Cushings. I told the doctor about the very recent information reported from Purdue University that the BRAF mutation test has shown positive tests where the dog did NOT have cancer. So when he did the ultrasound he said it did seem rather smooth, perhaps more like a polyp. Only a biopsy would tell us for sure and we are very hesitant to put him thru that procedure. He’s too small for a cystoscopy. Needle tissue aspiration creates risk of seeding if it does turn out to be a malignant tumor. So, I am going to have the internist take a look next week and get his opinion. Then I think if he concurs we will stop the NSAIDs for a month and then recheck. As far as Vetoryl, I don’t see any need for it at this point so we will let that go for the moment. He’s still all over the place as far as his diabetes. He has been a bit more controlled since we started Meloxicam but of course that reduces inflammation and can affect glucose. I guess I would rather try to work around the glucose swings since thus far none have caused any harm but I don’t like the increase in his liver enzymes. He’s always had Increased liver enzymes so we do have to be careful. So many variables here to consider! At least for the moment his Cushings seem to be a non issue. (For today anyway!)

[labblab]

As always, thanks for updating us. I agree with all the decisions you’re making right now, and gosh, it would be great if that apparent growth turns out to be a benign polyp after all. I’ll sure be hoping for the best when you head in for the consult. And of course keep us posted!