Cleo New Chemo Today -- Pls Wish Her Luck

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chriscleo

chriscleo

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decided to go whole hog and change chemo protocols (cleo has small cell lymphoma).

gonna order cytoxan overnighted and do the elspar today. elspar will be a single injection, with follow up tests next week, to see how she tolerates an injectable chemo. cytoxan will be pilled every other day.

vet believes she's still responding to CCNU but disease is progressing quicker than expected. before we do COP protocol, with GI issues vincristine injectable can cause, she wants to see how she does on the elspar injectable and whether number shift dramatically enough to warrant change to stronger COP protocol.

decided i'd just as soon be more aggressive right now when she can better tolerate it, than later down the road if she's gonna be sicker with more lymphoma progression.

we'll do this in about an hour and a half. would appreciate good thoughts on her behalf.
thanks.

prior thread: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=21470&p=213579#p213579
 
((((Chris))))
you most definitely have my good positive thoughts for Cleo.

Hoping it goes well for u both!
:YMHUG:
 
You are in our thoughts Cleo ... let's hope for good results on the new tx. Let's get squishing this disease into non existence.
Strength to you as well, Chris.
 
thank you. they all love her at the vet office so she got a lot of special attention. it was tough today -- very big guy was crying on the onco floor.

cleo's acting really good so far. maybe wanting to be babied a little more but ok now and good appetite (got elspar injected just under 2 hrs ago). gave anzemet, pepcid, and lantus an hour before leaving. guess i'd better keep the bupe handy. elspar is supposed to be hard on the pancreas. (cheryl, i asked about effect on pancreas but vet said the single elspar shot should be okay.)
 
Sending many many good thoughts and healing vibes your way - hope your baby has no problem with the drugs and hope they do help her imrove.

She is so pretty - those eyes are something else.

Good luck - all paws and fingers crossed here.

Emmy & Dude (& Mittsi too)
 
Sending many many cyber hugs for you both, and I so hope this can send the big C into remission..

(((((((((((((((((((((((((((CHRIS and CLEO))))))))))))))))))))))))))))))
 
hope all went well for your little girl. Let us know how she's feeling. If she is feeling punky, maybe she would like some little tidbits of pork chop. That's what Danny would eat after his chemos.

(((Chris)))

laur
 
thank you. it's hard to believe cleo is 17 and has gone thru so much in the past 3 years. she's still looking pretty darned great for an old lady with lymphoma, diabetes, cholangiohepatitis, pancreatitis. :)

posting her out of range numbers and their counterpart readings from the past 1.5 months' tests
(#s in brackets=normal range; results from Aug 2, July 19, June 23):

Aug 2.................................................July 19...............................June 23

ALT 174 [10-100] HI...........................Not Checked.........................Not Checked
BUN 45 [14-36] HI.............................Not Checked......................... 50 HI
i don't worry about BUN as much coz of hi-protein diet. creatinine + USG normal
WBC 16.2 [3.5-16.0] HI..........................27.8 HI.............................24.4 HI
RBC 5.6 [5.92-9.93] LOW.........................6.4.................................6.2
HGB 8.4 [9.3-15.9] LOW........................10.6..................................9.3
HCT 25 [29-48%] LOW............................32..................................28 LOW
-- Per lab note: Antech offers a feline hemoplasma PCR panel for detection of M. haemofelis, M. haemominutum, and M. turicensis, if we want to look for one or more species of hemoplasma.

Neutrophils 9234 [2500-8500] HI..............15290 HI...........................12688 HI
Lymphocytes 6156 [1200-8000].................7228...............................9272 HI
Monocytes 0 [0-600]...............................278................................732 HI
Eosinophils 810 [0-1000]........................5004 HI............................1708 HI


they ran reticulocyte counts (reflex) for me, too:

total reticulocyte 0.5 [0-1%] (Aug 2) ................... 0.7 (July 19)
absolute reticulocytes 28,000 [<45,000] (Aug 2).....44800 (July 19)
 
chris - i have a few questions, but don't put too much weight on them. chemo b/w looks different from regular b/w and i have too many cobwebs in my brain to remember the stuff. plus i'm half asleep and running around trying to feed, hydrate, etc ...
1. is cleo on any prophylactic antibiotics?
2. what has vettybean said about the consistently high wbc and neutrophils?
3. do the b/w reports show bands?
3. do you take her temp on a regular basis?
 
i should put the units of measurement in, too, but i'm not sure how to get the symbols to display.

no prophylactic antibiotics (you're talking amoxi, clinda, etc., right?)

path report says liver suggestive of mixed inflammatory response possibly associated with hepatitis, cholangitis, cholangiohepatitis, or other process (as did path when spleen was removed and samples taken around liver). vet said it could be any kind of inflammatory response possibly associated with pancreatitis or liver inflammation. no further histopathology done beyond multiple aspirates including of liver nodes.

re the numbers in general, especially july 19 ones, she feels the lymphoma is progressing faster than expected so it's time to zap it with something different. we're trying elspar to see if an injectable chemo is warranted alongside leukeran or cytoxan (or ccnu, for that matter, which she's now on).

she varies between slightly high temp and normal temp. i don't see bands noted in bloodwork anywhere.

what do you think, wcf? i value your opinion.
 
Sending all the vibes I can possibly muster up for Cleo! Positive and White lites and vines and everything!!!
 
Sending positive vibes for Cleo and you, Chris. I thought I had posted earlier, but apparently I didn't! All of those health issues and BW results make my head spin, hats off to you for managing it all so well! I hope Cleo is weathering the chemo ok.
 
update ?? or did you post it elsewhere and I missed?

does she get a c & S regularly done b/c of the roids? something to check out, if it hasn't been done w those white counts. the roids will hide the obvious symptoms.

neutrophil count being up so much could be from inflammation as well as a hidden infection. ( or both
I'd be kinda more worried about low counts on chemo, ya know?
If I am remembering correctly your vet was concerned the high counts were reflective of possible leukemia ?
was 6 years ago winnie had chemo. would have to go back and look. my memory not that good to comment further on cleo's bw .

as for possible infection from chemo --
do you have any ABs at home ?
We were given a supply of baytril so we could start toot suite in case her counts dropped from chemo and an infection took hold. I took her temp daily. we did it same time of day to keep other factors out.
and of course, I took it if she was off. ( and I have an ear thingy but I think we talked about that before?)
my instructions were to call the vet if fever and then start. or if off hours to start and then call first thing am.

Hoping all is well.
we heart cleo !! cat_pet_icon

((( chris )))
 
ack. i'm sorry, chris, i didn't see this till now.

chriscleo said:
no prophylactic antibiotics (you're talking amoxi, clinda, etc., right?)
Click to expand...
- yes. meowzi had clav for i forget how many days after chemo, starting on day 1. either seven or 10 or 14 days? because that's the time her immune system is very very suppessed - you'll see it in lower white counts - and the onco didn't want to risk her catching something that her immune system couldn't fight. the ab's wreaked havoc on her appy though - her tummy doesn't like clav. thank goodness for the happy pill. i think winnie's vet took a diff approach - have ab's on hand but not use till needed. depends on the vet and the patient, i guess.

i also took her temp, per cheryl's advice. we didn't do it daily but whenever we suspected something was off; the one time it was high, after we finished her course of clav, we called the onco. they called in a rx of clav to our primary vet and had her on it for another round.

she varies between slightly high temp and normal temp. i don't see bands noted in bloodwork anywhere.
Click to expand...
the slightly high temp - is it high enough to be worrisome? does she act 'off'? if you consistently get slightly high temp, i'd inform the vet.

if you use Antech labs, bands are in the CBC, in this order: differential, neutrophils, bands, lymphocytes, monocytes ... i notice some other labs don't report bands, don't worry if you can't find it.

cheryl made a good point that lower white counts are more of concern during chemo. i was wondering a suppressed bone marrow could be producing so much of it, but it sounds like it may not be unusual with her type of cancer? (i know nothing about lymphoma or leukemia). so just ignore my questions on the wbc if that's the case.
 
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