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)

Thanks for Giving...

It's been a wonderful Thanksgiving. We're fortunate that Mr. Max is getting a little stronger every day!  Today he went for a walk up at the park for the first time since May!!!  I finally figured out how to hook his Eddie's Wheels Cart up to Buster's old Pet Gear stroller and have it roll behind us until we got to a good place where Max could get out and practice walking.  He has been EXTREMELY frustrated the last few days with not being able to get up on his own. If he's not asleep and I move out of his sight he panics and starts to pant and kick and struggle and try and get up. The ER vet told me this would happen one night when I was visiting him in the hospital. She said as horrible as it may be- it's a REALLY GOOD sign that he's thinking, aware, and putting 2  and 2 together!

Max rolling across the field at the park

Max enjoying the sun

Max resting after a LONG roll at the park!   This cart has come in handy so many times with Buster, Buttercup and Max!!! Best Purchase!

Another CyberKnife Blogger!!! Meet Roxy!

I started Max's Blog to help others who have dogs (or other animals) who have had brain tumors and to help them learn more about options, including alternative medicine, chinese medicine, acupuncture, and cyberknife, which is obviously the path we ended up going down .    I had so many questions when Max started this process and I couldn't find any information out there about what he was going to go through day to day. The closest I could find were accounts told by human patients. I had a little bit of a clue that he was going to be lethargic for a while .. and eventually I'd start to notice a significant change.

In any event, Max had pretty good energy the first couple of weeks after Cyber knife and then he started to get more lethargic for a couple of months while the radiation started to do it's thing, and gradually his energy level started to improve.

Beautiful Roxy!

I recently received a comment about another dog who is going through Cyber Knife too!  Roxy!  The person she owns is also blogging about her experience on her blog, Roxy- Canine Brain Tumor - Cyberknife

I wanted to share this blog with you also so you have another resource!  The more we can all learn from each other, the better equipped we all are to manage expectations, and hopefully figure out what we all can do to give our pups, cats, goats or other animals the best shot at getting back to normal!

Click here to Read Roxy's Blog!

The Whisker Twitching is Gone!

About a month or so after Max's Cyber Knife he developed a facial twitch on the right side of his face. At first it included his right eye lid, right cheek, right side of his upper lip, his ear and a muscle that went across the side of his face. (His neurologist thought it was probably a muscle spasm vs. focal seizure because it was less active when he was asleep than awake.)

Eventually all I saw twitching was one muscle across his face which was tied to his hear and ran all the way to one row of his whiskers.  He just had a very slight twitch where I could see 1 black whisker twitch rhythmically. 

Today I was watching him sleep and was just checking on that whisker to see how much twitching was going on and there was absolutely NONE!  I can't even see that muscle in his face twitching or his ear!

I'm not sure what any of this means but I'd be a happy camper if I had a consistent twitch for months and it finally went away!

...5 Months Later! Test Results, Fur Shedding, a Fashion Show, and the Black Skin mystery solved

So... it's been 5 months since Max had Cyber Knife!  5 Months since he couldn't even lift his head or eat!  5 AMAZING MONTHS!  Over the last months we've had Max's blood levels checked and he's doing great!

His Chem Test (Idexx Lab):

TEST                  RESULTS              NORMAL REFERENCE GUIDE
BUN                      28 mg/dl                           7-27 mg/dl
CREA                    1.3mg/dl                           0.5-1.8 mg/dl
BUN/CREA                22
ALT                        158 U/L                          10-100 U/L
AST                         50 U/L                            0-50 U/L
ALKP                     408 U/L                           23-212 U/L


In the grand scheme of things here - this is Good!  We've had dogs (and cats) MUCH higher and even off the charts!  Considering Max has been on prednisone for 9 months at some level or another

T4 Test:

Results 2.2     Normal is 1.1- 4


Max's fur shedding seems to be slowing down a bit.  Maybe it was just the extra dry heat in the house from the colder winter weather.  We've increased his exercise a bit too to see if that helps - more walks.

I spoke with the PolyMVA folks - while his energy level was boosted significantly and I saw a lot of possitive changes  I wanted to make sure that his herbs weren't reacting poorly to the PolyMVA - nothing Max was on should have been reacting to it, but they did say that some dogs actually can develop a rash from it. One of the functions of the PolyMVA is that it helps flush toxins from the body (from meds, chemo, radiation, cancer cells, etc.. the body naturally flushes toxins from the body through respiration, the skin (the biggest one at the cellular level which is how PolyMVA functions) and when you go potty.  I had actually put Max on their highest recommended dose.. so perhaps that was too much. While he didn't get a rash - the shedding could be related to that.

Years ago Daisy and Max were selected randomly while walking along the street to be models in a Christian Dior fashion show (I DO NOT DRESS MY DOGS UP.. they're lucky if they are wearing a fancy collar! - usually they run around the house "naked" and their leashes have their collars attached) Anyway - it sounded like a fun event, so we went and they did a great job on the Cat walk, but Max completely broke out from the clothes they put on him. His skin got all red and his fur started to shed (he has a thick coat too so you'd think that would have protected him). It is possible that this was just his way of reacting to it.  He is the first dog out of all of our dogs who have been on it who has had this reaction. (Buttercup's coat has gotten beautiful and very silky and healthy.) 

So the plan is to keep him off it for one more week to let it completely clear his system and then start him back on a lower dose and see what happens.  (There is NO iodine in PolyMVA we found out)

There is also the possibility that it's just from being on the Prednisone for so long. That has been known to make fur coarse and cause shedding, which are also signs of Cushing's Disease, which can be caused by low thyroid #'s although I'm told that if he were to completely go off the prednisone (weaned off - you should never stop any medication, especially prednisone suddenly - and always consult your doctor/vet first) his fur would grow back and be healthy.  Now given the option of being bald, vs. being involved in a perpetual game of dizzy bat, I'd go for being bald.  As Max's neurologist pointed out they do make some very fashionable dog sweaters these days..   Anyway - this is always a possibility. We have not done the Cushings test at this point.

We're still going to try the fish oil and see if that works (ran it by Max's holistic vets and his neurologist and got the thumbs up from all).

Another thing I had learned this morning was that a number of the dogs in a cancer support group we're involved with have also lost their fur while on steroids, but it did manage to grow back. Many said that the fur loss actually got worse after they started tapering the steroids back (prednisone, natural hydrocortisone, etc) Which is what we've been doing with Max - he's at 10mg every 4-5 days now). 

One person in the group posted:

"My dog (not my cancer dog) had fur shedding when she was on prednisone. Actually, it got much worse after I tapered her off and stopped it, so i think it can happen with a low dose. She had a low thyroid but within normal range. Her normally soft luxurious fur also became very coarse. The vet gave her a chinese herb called Rehmannia 6 and within days her fur was soft again and stopped falling out. I don't know if you can give it at the same time as steroids, maybe you want to ask your holistic vets about it."

DON'T GIVE YOUR PETS ANYTHING WITHOUT CHECKING WITH YOUR VET FIRST

So.. I think we're going to talk with our holistic vets about Rehmannia 6 and find out what it is, what it's side effects are, how it reacts with the other herbs, supplements and medications Max is on,  and if that might be a possibility to help as well 

A  few people also said that their dogs skin had turned black - just like Max's did!  One person was even able to say what specific medication turned her dog's skin black! 
She told us her "oncologist explained that one of the "side effects" of doxorubicin could be the "darkening of skin- the color changes ".  

While I didn't put Max on this medication, he was on it when he was in the hospital in NY for Cyber Knife!  And it was within a couple of weeks that I started to see his skin turn black.. not pretty but as far as I can tell no bad effects.  His fur has all grown back where he was shaved and the skin had turned black and I don't think it's black under there any more.


BUTTERCUP UPDATE:
Just a quick update on Buttercup. Her surgery went really well. Her food has recovered very well - nice scar! Looks good and the pathology report came back that we're all clear - it's all out, clean margins, nothing to worry about any more!  She's been running around and going for walks and I only saw her try to lick her stitches once.

And a few photos of Max working hard and monitoring the landscaping going on...

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..