Good news for Karl – he is doing very well!

I’m starting this with the end so no one panics as they read through this and I need to tell everything in order to explain where we are now.

On August 1, a little over 3 months ago, I took Karl to Flathead Pet Emergency, a 24/6 Pet ER about 18 miles from my home. He was uncomfortable – restless, and having difficulty pooping (I’m not going all clinical in my choice of words :)!) The ER vet found enlarged prostate. In a neutered male of Karl’s age, it is very rare for this to be anything but prostate cancer – a very aggressive cancer in canines. No surgery, no treatment except keeping them comfortable until you can’t. They aspirated some fluid from the prostate and overnighted it to a lab to confirm. In the meantime, on the very slight chance that it was infection, we started on anti-biotics and Rimadyl (canine aspirin).

Karl seemed nearly immediately better and steadily improved. Regardless of the ER vet’s dismal prognosis, I had high hopes that Karl was a rarity. I enlisted a small band of prayer warriors praying for healing for Karl and wisdom for me and the vets. I spoke to my regular vet and we scheduled an ultrasound and blood test. Meantime, the prostate aspirate was reported inconclusive but suggestive of cancer. On August 10 the ultrasound showed the prostate was normal and the bloodwork showed none of the markers that are typically there for prostate cancer. I was elated. ( Whitefish Vet ) As a precaution, everything was sent to a veterinary oncologist for review.

The oncologist still felt that a cancer was likely. A urinalysis confirmed “TCC”, transitional cell carcinoma, which is a bladder originating cancer. It is a non-agressive, slow growing cancer and many dogs live with it for a year or more. They felt we caught Karl’s early. The oncologist recommended 4 more weeks (6 weeks total) of antibiotics and a switch from Rimadyl to Piroxicam. Piroxicam is doggie Alleve – a stronger anti-inflammatory than Rimadyl and there is concrete evidence that it reduces TCC tumors for some time…eventually the TCC becomes accustomed.

4 weeks in on the antibiotics and 1 week in on the Piroxicam, Karl got worse. He was nauseated and lethargic. His left and then his right eye got very red and the lower lid came up. Irritated eyes are a possible side affect of the long course of antibiotics. The lower lid raising could have been that as well as it is a symptom of pain. We got salve for his eyes. He got worse.

I took him to Wayfarer’s Park on that Friday – his favorite spot. We walked about 50 yards from the car and he couldn’t go further. I asked a family on a picnic to hold him while I got the Jeep. When I returned, he was all waggy tail with the children who were petting him. He wanted some of their chicken and I ok’d that. It got me thinking…he was eating and going and seemed to feel better with food. I started to suspect the medication and stopped it.

He came around, but slowly. It was that weekend that I wrote Transition post. It took about a week but his eyes cleared, his tail started wagging regularly and finally it curled up again. His energy came back. I decided enough with the antibiotics and switched back to Rimadyl. He continued to do well.

I keep a chart in a spreadsheet of how I was feeding and medicating Karl and I sent all to my vet. We spoke and they wanted me to give the Piroxicam another try as soon as I was ready. The reasoning was that hopefully it was the combination of it and the antibiotics that had caused the problem and Piroxicam would give Karl the longest time.

We tried it again, this time with a stomach coater, Carofate. About day 6, he started becoming uncomfortable and I stopped.

Thinking that I couldn’t give him the Piroxicam, I thought that the next thing would be to supplement the Rimadyl with herbal/homeopathic treatments. I made an appointment with Dr. Calm, a local DVM who also specializes in homeopathic and herbal therapies. Waiting for that appointment, I did some reading on my own.

By the time we went to see Dr. Calm , I realized that I had failed to follow up on some things with my own vet. Like, where was the tumor or tumors. Are they all inoperable? The urinalysis test for TCC is prone to false positives – they felt Karl’s was not false since he had been on antibiotics for some time before the test. Since I had the appointment with Dr. Calm, I asked her all of these things. She counselled returning to my vet and getting another ultrasound of the entire area.

Two weeks ago, this follow up ultrasound turned up nothing. This time they looked in the bladder and entire abdomen. Nothing! We redid the Urinalysis and added a second test. It was still positive for TCC but also showed protein and high white count which can cause a false positive. To eliminate contamination from “stuff” on the penis, they did a procedure to draw urine direct from the bladder. The first tests were still inconclusive. They cultered the sample and nothing grew so no infection. But not much else either.

Now we are up to yesterday. Although we don’t have anything that conclusively says there is no cancer, the fact that there is no visible tumor and Karl is doing VERY well are giving everyone reason to hope that it was infection only. That’s what I believe at this point.

Piroxicam has been shown to be effective with an every other day dosage so they suggested that I try that with Karl. And we added Pepcid to the routine as well. If he tolerates that, we’ll do that for a bit and see how things go. Piroxicam is often given for arthritis – there is no downside to continuing to give it, if he tolerates it.

If, in a month, there are no new symptoms and no evidence of tumor, there will be a choice of staying on it or seeing what happens off. There is also an option of travelling to Pullman, WA, south of Spokane – to Washington State University where they have state of the art diagnostic ultrasound as well as MRI capability.

At the moment, Karl and I are enjoying that all seems back to normal and I’m letting the options rest. I have some more questions. I have found that the answers for what to do and when to do it come in the peace and quiet of reflection and prayer vs a frantic searching or rushed decision.

Karl looks good. We are back to our typical long walks and play sessions. We’re looking forward to playing in the snow and enjoying a Montana Winter. His coat has come in heavier than ever before. Local speculation is that we will get a real winter this year – hoorah!

Karl’s good news.

“We know nothing of tomorrow; our business is to be good and happy today”. –Sydney Smith