Hypercalcemia

Tues. Sept 22nd - another rough day today - wonder if these are going to become the norm. Got the morning call from the Vet Tech and again she only had his temp, which was normal at 101.8, good to hear but the CBC is what we wanted. Steve visited Sam at lunch, he wouldn't eat but had a good visit. When Steve left ECVR he got the latest CBC results. The WBC and platelets are both normal but Sam's calcium is now higher than it has ever been at 15 mg/dL.
What does this mean? Several things:
(1) The chemo only lasted two weeks AND made him very sick
(2) He is now back at risk of kidney failure
(3) We both cried most of the afternoon

We discussed our possible plans & sent the CBC results to Dr. Ruslander at VSH.

3pm - Dr. Stoll from ECVR called. Having returned from vacation she reviewed Sam's file and recognized the discouraging calcium trend. She had spoken with a colleague, Dr. Mary Lynn Higginbotham, at Kansas State University, to ask her opinion on Sam's poor response to the Carboplatin chemo. Dr. Higginbotham recommended another chemo drug that Dr. Ruslander had suggested. This drug, Palladia is not on the "market" yet and is primarily meant for mast cell tumors. There is anecdotal evidence of good responses to Sam's cancer, metastatic anal sac adenocarcinoma & VSH can administer it. We asked Dr. Stoll to explain the signs of kidney failure. Our main concern is Sam's comfort and we needed to hear what we might be signing him up for if we stop chemo & do not pursue other treatment. Not an easy list of symptoms to hear but we owe it to Sam to know the truth. We explained that we want to bring him home and will give him subcutaneous fluids. She agreed to his coming home Wed. & will put him on an appetite stimulant & IV fluids for the next 24 hours.

4pm - We spoke with Dr. Ruslander and got his "stay in the game" coach. He is still in favor of radiation. We explained, at this point, we'd prefer to try Palladia and do a CT scan to see where the cancer may have metastasized. He agreed with our plan and recommended Prednisone to help lower his calcium in the short term and then we'll schedule Palladia chemo next week.

8pm - We visited Sam tonight & took Moo along for the visit. Had another quick chat with Dr. Stoll. She spoke with Ruslander & started Sam on Prednisone. She said he commented that he thought we should really consider radiation. We'll have to see, at this point Sam has had such bad luck with each step that we don't know if we can put him through more. After such a bad news day we are still looking forward to bringing SamDog home Wednesday. A Vet Tech said she feed him ½ cheeseburger today but he wouldn't eat for us.

Below are two photos of Moo & Sam - one on our deck the day we brought Sam home from the shelter in Oct. 2000 and one of them tonight - both drinking water together.
A small thing they do but we've always enjoyed seeing & hearing it.