Just the Toes

The following is Max doing a foot soak to try and remove some of the dead (necrotic) tissue from his gangrene.  This is after 18 HBOT treatments.. Today is 5 days after his 18th treatment and we are not just left with dead skin on his toes... there is new tissue under the dead black skin.. so we're soaking it in salt water to try and soften it up so that it comes off... I am beginning to thing we need to get Max a bath with those little fish that eat dead skin.... (not sure how sanitary that is... but they'd have a field day on his foot)

Max catches a fish...

Max looking for stuff floating in the creek

I think we've finally found the right dose of anti-seizure medication! While I'd prefer Max not to be on any at all, I think this works for him. He's now taking 125mg of keppra 2x a day.  He seems to be more himself, sharper, curious, and active.

This morning he got fed up with Rex pushing his way in for attention and decided to let him know about it!  That's the old Max we know! And boy was Rex not expecting it!I was petting Max and Rex shoved his way in between me and Max and Max lunged at him and growled to let him know that wasn't acceptable!  Go Max!

Max examining oysters from the "Save the Bay" project

Video of Max & the oysters

 Video of Max catching Fish... and eating it

Later this morning I took #2 and Max out for a walk in the woods and down to the water. We met a little guy named Tyson who had just been adopted last week and was having a great time with his new people! he's a 10 yr old Tibetan Spaniel, and has wonderful new owners!  So happy to hear someone adopted a senior dog from a shelter! He was going with his new people down to the dock to go fishing!  That was where we were headed!  Max loves to go down to the dock and watch things float by in the water and hasn't been down there in a few months.

Max & #2 heading back from the Creek

 I didn't know how he was going to respond, but he enjoyed hanging out with Tyson and when we got down to the dock he walked the edge looking for floating things.. there wasn't much in there though, so he watched Tyson's dad fish, and then a man came down with a big cooler. He's a teacher and had a school project going under the dock as well as inYorktown where they were helping to replenish the oyster population in the York River and the Chesapeake Bay.  Max turned right back into his normal curious self as soon as he pulled the first basket of oysters up!  There were little shrimp flopping around, a few crabs and some little bait fish.. and some good smells!    Max was very intent on catching these fish! He tried to step on one, then caught it in his mouth, we had to remove it.. and then caught another and ate it!

Max enjoying his walk in the woods

2 Back seat drivers

I think that's the first thing he's ever killed in his whole life..  but down it went after a big crunch..   Hopefully he doesn't catch anything from it.. nasty.. but he seemed to have a really good time!









After our visit at the dock and the creek and adventures catching fish, crab and shrimp (and leaves, and mud) , we headed back up into the woods and went for a little hike!  Max seemed to really enjoy this as well but I could tell he started to get a little tired after a while so we headed back to the car..  he kept up a good pace though and was alert, watching leaves fall from the sky and running over to see what fell. He also chased a frog/toad through the leaves!





When Max & #2 got up to the field house they both remembered that the guys who worked there toss bread out in the mornings for the birds and deer and they went over to look for some.. a little late though! It was all gone!


It always seems like someone is looking over my shoulder!

Max heading back to the car.. but side tracked by a John Deere mobile..   (notice - he's walking in a relatively straight line and should now pass a sobriety test if pulled over while he's driving!)

Medication update

Just got a call from the neurologist's office and we're changing Max's dose of Keppra from 500mg 3x day down to 125mg 2x/day and seeing how that works...

Max's Neuro Check up and anti-Seizure meds

Last week Max went in for his neurology check up, the first since his Cyber Knife.  He's been doing well.  We talked about how his hearing seemed to disappear when we lowered his prednisone dose to 10mg every other day so we decided to keep him on 10mg every day for now.  We're also working on weaning him over to the natural hydrocortisone. We did another full week of 10mg of prednisone every day, then the following week 10mg or prednisone every other day and on the other days we did 20-30 mg of natural hydrocortisone (soy-based and less effects on the liver/kidneys).  Now we're up to 10mg of prednisone and 2 days of natural hydrocortisone, then 1 day of prednisone and 2 days of natural hydrocortisone.  I'm happy to say Max's hearing and vision are great and I don't see any issues this time!

Dr. Young checked Max's eye as well and said it looked like it was healing well.  He could see through the cloudy scar tissue in his eye. He's doing well with his eye drops and anti-biotic ointment. He goes back to the eye doctor for a re-check next week,

The other issue we talked about were Max's anti-seizure medications.  All of the neurologists who have taken care of Max have suggested he be on anti-seizure medication .. just in case.  Dr. Joseph said he has seen dogs who have never had seizures have really bad ones that seem to come out of nowhere, and it's better to be on a preventative.  My one concern is, Max is not doing very well with these anti-seizure meds. He's not himself, and they make him very drunk.  He was first prescribed zonisamide. Max weighs 48 lbs. He was prescribed 200mg 2x/day.  He was pretty much a mess on this. It does take a while for them to build up a tolerance to the medication, much like you build up a tolerance to drinking or any other drug. Max had a really rough time and didn't seem to be building up any tolerance.  He lost his appetite all together, would vomit and had really bad diarrhea, and was extremely wobbly, anxious and walked around like a drunk guy.  I seemed to be able to get him to be ok on 100mg 1 time a day - given at night.  Dr. Young wanted to try at least 100mg 2x/day, but it's hard for Max to function during the day and we felt like his quality of life just wasn't there. The hard part is- you want them to have a good quality of life.. We went through this to save him, not to have him live the rest of his life in a fog.  Max is the Alex P. Keaton of Dogs!  He's always had serious OCD... He likes everything in it's particular spot, can't stand it when a dog can't walk in a straight line and needs to go run over and smell something..

Dr. Young suggested switching Max over to Keppra. He was prescribed 500mg 3x day.  The problem with this dose was that we gave Max his dose at 6pm and he did not wake up until 3AM the next day. Not even for dinner, or breakfast or to go out!  I couldn't even get his 2nd and 3rd doses in.  The next day I tried 250mg at night and he went out again and woke up to eat breakfast and then went back to sleep and around 1pm got up - very groggy, went potty, ate something, took a short walk, then another 250mg and he was out again until the next morning..   At this time, I'm hoping that he builds up some sort of tolerance to Keppra.   The positives of the Keppra are that he is not nauseous, his poops are solid, he doesn't seem very agitated, especially if I can get him out for a good walk in the afternoon.  He will sleep through the night.

I don't like to be woken up by drunk dogs in the middle of the night!!!

We had one little instance last night though, he didn't get his walk and was getting his exercise by walking all around the house (which he's always done if he doesn't get to go for a walk - think of a dog who needs to go to the gym religiously every day.. that's always been Max - so this isn't too abnormal for him) Anyway - at midnight he was doing his laps, and was drunk from his medication and I suppose stumbled over the dog bed where our rottie mix was sleeping, and she's apparently had it with Drunk Max. She jumped up out of bed with her horrible growley voice and decided Max needed his nose pierced.. you know.. just in case he decided he needed to get a nose ring with all the drugs he's been taking.. then she figured she should also pierce his tongue while she was at it... just in case Max REALLY wanted to be a rebel.. (Again - this is the equivalent to Alex P. Keaton getting a tongue and nose ring..... Sober Max has severe OCD... Drunk Max.. not so much.)

So Ms. Buttercup spent the rest of the night locked in Tom's office. She has yet to apologize to Max.  Max seems to be fine today.  Normally Buttercup is a lovely girl... like the rest of us though, she doesn't like to be stepped on or have someone fall on her in the middle of the night while she's sleeping, regardless of whether they can see or hear and especially not if they are drunk!

The Resourcefulness of Max The Dog

My little friend Max has been on a mission this morning to steal the cat's food! Poor Tulsa the cat has kidney disease and seems to prefer to eat in bed. Well this morning Max decided that was a great idea and wanted to take part in Tulsa's breakfast! After repeatedly being told to stop trying to jump on the bed, he then decided to pull the blanket off the bed.. along with the cat food.. !

Max trying to get a good hold on the blanket to pull it off the bed

Got it! and this is how I woke up this morning!

Trying another way to get to the cat food

Still trying.. maybe he can PULL the blanket off the bed!

Working it!

Cat food in sight!

Whoops where did he go!

He's back!

And another attempt at pulling the blanket with his paws

And he's gone again - kind of like whack a mole (but I would never whack max)

And there he is again.. at least his ears!

Up again!

Whoops - slipped footing!

Poor Tulsa is irritated that max is trying to steal his food.

"Really... can you please stop him?"

My goodness! Dog on a mission!

Some confusion as the bed is being attacked by Max

"I'm going to get your breakfast!"

"I'm just going to grab this blanket you are on and pull!!! Hold on tight!"

"That bowel is getting closer!"

"HA!  I think I have it!"

"Ha ha ha ha!"

"Get In My Belly!"

"Pardon me, but do you happen to have any Grey Poupon?  ... and a Fork?"

11-5-11 - Max's Day in Colonial Williamsburg

Today Max went for an outting in Colonial Williamsburg. He did pretty well but I think he was tired. He did take his anti-seizure medication today and prednisone which usually makes him sleepy. He's had a hard time hearing today - he can hear really loud noises and other dogs barking (except little doxies who are telling him what to do apparently), and I'm not sure how his sight was. The wind outside may have been drying up his right eye and it could have been hard to see but his nose sure was working!  There are a lot of good smells in Colonial Williamsburg! Max even tried to crash a wedding but was told if he didn't have an invitation he wasn't allowed in. We didn't see any sheep on this visit, just the horses which he normally will chase down, but today he just walked right up to them, wagged his tail and then turned and walked away. Definitely not himself entirely yet... which reminds me we have a ways to go.. or he has a new found appreciation for his friends the horses..

Max outside of the Bruton Parish Church on Duke of Gloucester Street in Colonial Williamsburg

Max and Buster walking along in Colonial Williamsburg

Max trying to crash a wedding at Bruton Parish.. he was denied.

Max and Buster Running around the corner at Bruton Parish to see if they can sneak in through the grave yard..

Max on Governor's Green in Colonial Williamsburg (Governor's Palace at the end of the green)

Max off leash on the Governor's Green in Colonial Williamsburg

Max & the Horses. A few months ago he'd try and ride a horse.. today he just wagged his tail as he went over and then turned around.

Max in the Colonial Gardens

Max wishing Buster would pick up the pace and stop sniffing EVERYTHING

Max waiting for Buster AGAIN..

Guess who went for a walk today!

Guess who went for a walk today!  You guessed it! MAX!  We went up to the woods and he walked a whole 1/2 a mile on the short trail!  It was a slow walk at first. He wanted to take in all the kids at the playground and the people playing volley ball. Actually I think that was extremely overwhelming for him.  He kept taking 2 steps and then stopped and tried to take it all in - kids laughing, squeeling, swinging on swings, sliding down slides, making sand castles, baby crying, bicyclists, people playing basket ball, and volley ball, and a goth wedding... (yup... all sorts of people dressed in black and red for the wedding coming by and saying hi to him on their way out).  Once we got past the playground, he was a pup on a mission... or gravity took over.. or a little of both and he was pulling me down the hill.  He LOVES to go all the way to the bottom of the hill and walk on the fishing dock and bark at the fish and things floating by.. but not today. He pooped, then got to the picnic shelter and decided it was time for a nap.  We hung out there for about 20 minutes and then started through the woods back to the car.  Not as many people, but lots of smells (his nose is working again), he spotted some birds and squirrels but opted not to go after them, smelled some plants too. I was trying to walk really slow so he would go slow, but Max would have none of that, however he'd stop every 20 ft or so. He was a bit wobbly - like he was drunk.   Maybe a little light-headed?  But once we got going in the woods, he wanted to keep going and didn't want to take the short cut to the parking lot. In fact when we got to the end of the trail he made a left and wanted to do it again.  At that point we ran into Sarah - a yellow Lab who came over to say hi so he had some time to rest while the people chatted.

Chinese Herbs, Alternatives & Diet

Max at Vet getting acupuncture 10-13-11

I didn't get into much detail earlier on about the chinese herbs that Max has been on and is continuing to be on, but for those interested in alternatives, including Traditional Chinese Medicine, Acupuncture, Homeopathy, etc. I thought I'd include a little more detail for you.

After Max was first diagnosed, we went to our holistic vets (Veterinary Holistic Care in Bethesda MD where we see Dr. Kitty Raichura, and Dr. Tracy Lord, who practices in Richmond and Williamsburg VA. ) Here's what we did (It's important to note that I didn't give him all of this stuff every day - only when I felt like he needed it. He did get items 2-7 daily)

1. Weekly Acupuncture to help strengthen his energy and immune system 
2. MilkThistle 2-3 capules daily to help support his liver and kidneys while on Prednisone
3. Astragalus (we used both capsules and Chinese Flower brand formula depending on what he'd eat) to help strengthen his immune system
4. Stasis of the Mansion of the Mind (Chinese Herb prescribed to help move energy / chi  in his mind and help clear any dieing tumor cells
5. Wei Chi Booster - to help increase his energy
6. CAS suppliements for Dogs - to help boost his immune system
7. Tumeric sprinkled on his food to help his immune system and reduce swelling (Tumeric is a natural killer (NK) agent)
8. IP6
9. Poly MVA
10. Homeopathic mixture that was custom made for him by Dr. Lord to help with his specific symptoms

 I stopped everything except for the Milk Thistle and Astragalus when he went in to the hospital.  We started him back up on Stasis of the Mansion of the Mind and Wei Chi Booster 2 weeks after his last CK therapy.

We also started to use a Natural Hydrocortisone pill that we weaned him on to to replace the prednisone he was on.  The Natural Hydrocortisone is soy-based and I do not feel it is nearly as strong as the prednisone. For every 10mg of prednisone he was on, he took 20mg of the natural hydrocortisone.  Sometimes I felt like he needed more.  We did get him down to 5mg of prednosone every 4 days and 20mg of natural hydrocortisone ever other day before he went down hill after chasing that squirrel. I've heard different doctors thinking different things about it so if this is something you are considering weigh all the options and facts with your vet. The positive is that the soy-based natural hydrocortisone won't mess with liver and kidney functions as much as the prednisone does, in my opinion through, and I have no medical background, I think the prednisone is more effective, but that doesn't mean you can't use them together or that the natural hydrocortisone may not work better for another patient who isn't as advanced as Max was.  I think it's very important to remember that every patient is unique and I am just letting you know what we did and what worked for us as well as what options you may have and may want to discuss with your vet.

We have had a lot of success treating our pets with homeopathic methods, Chinese Medicine, Acupuncture and alternative therapies including ozone therapy for other kinds of cancers.

Max has been on an anti-cancer diet most of his life which is probably why he doesn't have any sign of cancer anywhere in his body. Meningiomas are benign masses.

His typical meals include:

1. Grilled Chicken usually - sometimes steak (1x every other week)
2. Fresh Veggies or a 1/2 cup of Honest Kitchen Brand Freeze Dried Veggies (Preference)
3. Scoop of organic canned pumpkin

He has been completely grain free since he came to live with us when he was 11.

He loves to eat frozen broccoli as treats, or cantaloupe, blueberries, apples, carrots, cucumbers, or other veggies. The dogs also get frozen raw bones with the marrow inside. I usually keep them frozen because they last longer, are less messy, and keep them cool in the summer. I'll also refill the raw bones with organic salt free, sugar free peanut butter and freeze them too.  The dogs also love roasted turkey, and salmon which they occassionally get.  We have very rarely ever bought and fed our dogs commercial dog food and when we have it's been either The Honest Kitchen or B.G. (Before Grain) products.

Protecting his turf

Just 2 weeks since we got home from NY and 2 weeks and 1 day after Max's final cyberknife treatment, he ran right out the front door, across the front yard and barked at the strange people coming out of the woods with the rest of our dogs... as you can see he's pretty much back to his normal self!  I'd say his vision is a little bit off from falling in the gravel and injuring his eye when his balance was really bad 3 weeks ago - he was a little surprised to see me at the front door, but aside from that - he's completely normal, barking, hearing, interacting, playing and protecting the house!  (Max is the little yellow dot in the distance.. in the sun... in the middle of the video in the beginning)

It's great to see!

10-13-11 Seems to be Totally back to normal!

Today is Thursday 10-13-11, not even 2 full weeks after Max finished his cyberknife treatments and he appears to be totally back to normal! I woke up this morning to Max in his dog bed next to me watching me sleep like he used to!

He spent the entire night there!  Since we've been home he's been sleeping out in the hall by himself, which is totally not like him. He has always been the dog who would never let me out of his sight!

He did get up 3 times last night to go out, but made sure he woke me up to let him out each time. Both eyes are very clear! He even jumped over his brother Buster who was snoring in the middle of the floor to get out of the bedroom!

This morning he actually ate some dog food (not that we normally feed him dog food, but it makes it a whole lot easier to get his pills down with mushy dog food.  He actually was excited about it! 

 Once I slipped his milkthistle and astragalus capsules in his dog food he became a little more leary of it... He ate one capsule but not the other and I can't tell which so I'll have to try again. I definitely am beginning to think his lack of appetite may have been him not wanting to feel drunk with the anti-seizure medication.

After he finished his breakfast he went and did his rounds trying to steal everyone else's food. I did catch him chowing on Rex's raw food.. not so sure I want Max eating raw yet.. maybe when he's completely off the prednisone and his immunity is

back to normal, but it's good to see he's interested in it again!

Last night he even snuggled up with Buttercup (his sister) and lay down with his head on my foot, he's interacting more and more with everyone!

When he went potty after breakfast he decided he was going to be super man and ran and skipped a step coming back up into the house... He's definitely MUCH more stable on his feet. I don't see any unsteadiness or wobbling any more! No twitching, no head tilting, no leaning, no circling and his eyes are both blinking at the same time!  I LOVE IT!  I'm very hopeful he keeps improving from here!

The Wild man is back!

So... after a few days of Max sleeping 22 out of 24 hours and not being interesting in food, I decided to see what would happen if I completely took him off of his anti-seizure medication for 24 hours.  Possibly not the wisest idea in the world, but Max never had a seizure prior to cyberknife, and only had one seizure since that was just over 1 minute.

The results of my experiment were that Max ate a salad, lettuce and all! a bag of frozen broccoli (one of his favorite things), 1/2 of a roaster that he split with the cat, 1/2 of a chicken breast, some more curried chicken, he took a long walk outside around the house and then up and down the driveway, he started to follow spoken commands again (like go potty), and both eyes started to blink at the same time (prior it had been looking like he was just alternating eyes and winking at you!). He also decided it was a good idea to go into cahoots with the beagle and try and steal the cat's chicken by flipping him off his bed, then he tried to get into the cat's bed and steal more chicken.. and got himself swatted, but still he remained undeterred...   The old Max is back!

Then I thought it might be a good idea to put him back on his anti-seizure meds and he's not very happy with me at the moment. I wonder if there's something that he can take where he can be more himself.  It may be better that he's not pushing the limits at the moment, but I can assure you, when not on anti-seizure meds.. he is 100% the old Max. 3 weeks ago he couldn't even hold his head up.. now he's getting into trouble!

He's down from 40mg of prednisone to 10mg too! I know we still have a long road ahead of us, and he's doing amazingly well!

Curried Chicken... ???

I just don't know what to say!  Max (and our kidney failure cat) are both on hunger strikes tonight. Max will only eat curried chicken and he goes NUTS for it! I'm not sure how good it is, since I didn't make it.. I know the chicken is good for him and the tumeric is good for him but not so sure about the mayo or curry... Who's ever heard of a dog who loves curried chicken?!

Today is the first day since Cyberknife that we started to wean Max off the prednisone. He is now down to 10mg a day. When he went into the hospital he was on 40mg / day.  It's all very amazing!  Of course he spent the whole day sleeping, much more than he normally has been. He's been dreaming quite a bit too today, lots of chasing things, and barking in his sleep.

He got up a few times today to go potty and see how his new fenced in yard was coming along.  He even walked all the way across the front yard and around the corner of the house - he didn't follow me in the woods though, thought it might be best to lay down in the dirt and just watch.. not really up for any adventures.  That's the furthest he's wandered around the house in a while. He's bored I can tell, but hasn't really wanted to go anywhere either. Energy is still low  which we expected.. yet he can run through the house and check every room looking for me pretty quickly if he wants to and he'll still jump up and bark with the rest of the animals.  He has a little skip in his step and he tried to hop up over the stairs this am too. He did manage to hop OVER buster earlier today as well.

Some photos from yesterday 10-9-11

Information about Cyber Knife

I've received a few emails asking for more information about the CyberKnife Procedure so I wanted to post a few links for people to check out. I found these helpful.

• Cyber Knife Society
• Animal Speciality Center in Yonkers NY
• A Brochure on CyberKnife (this is intended for humans but it's more or less the same for animals)
• The CyberKnife Website
• Dogster Blog from other dogs who have been through Cyberknife or are contemplating it

** There are patient forums out there for humans who have undergone CK, which is interesting because they can put into words what your pet can't. (CK is not just for dogs, there was a cat in there when we were there and I also had heard about a goat who underwent it too!).

The main difference between the animals and the humans is that the animals need to be sedated during their procedures.

We were up in NY for 5 days. Monday was the planning day and they mapped Max's brain using CT and MRI scans and planted gold seeds (inert metal) to help the cyberknife robot triangulate and hit it's target exactly. Then we had Tuesday off, Wed, Thurs, and Fri max had CK treatments and then he was done!

10-7-11 Update

Today mark's one week since Max's Final Cyberknife treatment and all in all he's doing much better than I ever expected, and I"m very happy about that. He had a seizure a few days ago that a little more than a minute, the kind where everything stiffens up and he starts running in place, a little foaming at the mouth, peeing on himself.. and then when he came out of the seizure he threw up. Unlike my other animals when they seize, Max decided that he needed to run a marathon for an hour after. He ran all over the house and our yard, non stop for an hour (and here I was wondering if I had over done it earlier in the day when I took him for a walk!

The neurologist on call prescribed an anti-seizure medication for Max, and this is where we learned that there are absolutely NO 24x7 pharmacies within 30 minutes of our house! Personally I don't think the anti-siezure medication is good for him - at least the one prescribed. He has had heart palpatations since, and has had an upset tummy. I can see him breathing from the lower end of his tummy and it's more labored, he also vomits every 12 hours or so after he is dosed this medication, even on pepcid or zantac. One of the side effects of this medication is to feel drunk and woozy. He's definitely wobbly so I'm guessing that that has something to do with it.

Last night Dr. Bush suggested we try pepcid and boiled chicken and rice for Max to see if that will help him eat.  So this morning that's what I made for him... and it worked.. He at our other dog's breakfast!  (not the chicken and rice). So our next test is to see if it stays down

For anyone who is concerned about cognitive skills and cyber knife. Max is his normal self, a little more tired than normal but that's a normal side effect. In humans I've read that the lethargy can last anywhere from a couple of weeks to a couple of years, and I'm sure it depends on where their tumors are, and the medications they are on.  The prednisone itself makes Max really tired. He usually sleeps very soundly for a good 4-5 hours after taking his prednisone dose and then he's his normal self. With the anti-seizure medication he just sleeps all day and night long.

He knows to come and get me when he needs to go to the bathroom, and actually will search the house for me if he can't find me. He still waits in the front window for me when I go out. When he's not on the anti-seizure medication he's more curious and wants to sniff around outside and check and see what the contractors are working on or who is coming to the door.  He still barks and runs to the door and then comes to get me when the door bell rings. Last night he even engaged in a little body slamming with his rottie sister, Buttercup.  But his energy does come in short bursts and that's ok.  He just needs his rest and I"m anticipating that for at least the next month he'll be doing a lot of resting.

At meal time he still comes to the kitchen and examines what everyone else is eating, even if his tummy is too funky to eat. He'll still also herd the shepherd out of the kitchen as well.  Last night I heard him give off a low growl to our beagle when he was thinking of trying to steal Max's food, and a low growl to the cat who wanted to sleep on the same dog bed.  He's working on gaining his strength and getting back to his normal self.

I am not sure but I think loss of appetite may also be a side effect of radiation though too - or I may be getting that confused with chemo, of course the prednisone should be making him eat cardboard.  I"m sure his appetite will eventually make it's way back after we are able to stabilize his tummy.  This happened when he first went on prednisone as well.

(Above - Max had run to the window to see what the dogs were barking about - still not 100% - he'd be the loud one if he was and that tail would be waiving like a flag.. but he's starting to get back into the swing of things a bit)

(Above - Max around 6pm today. Not barking but you can see he's still a part of the pack and still wants to know what's going on and obviously could hear the alarm!)