Last night, just before bed, I ran my hands over Arran’s body. That’s when I found the enlarged lymph node near his left “armpit”. I checked his other nodes. The ones in his back legs, which were enlarged when I first found out about his lymphoma, were not swollen. I thought I could detect a little swelling in the nodes under his jaw.
It’s possible that this isn’t lymphoma roaring back to life, but I think it probably is. I’ve noticed Arran is a little shaky lately, too.
He has a vet appointment on Wednesday. It will be his 16th week, I believe… and he’s already done better on chemo than I ever thought he could. He made it to his tenth anniversary.
I don’t know how much longer he has, but I suspect his time is drawing close. I’m kind of ambivalent about it. Yes, of course, I will miss him. I love him dearly. When we lose him, it’s going to leave a huge hole. But I also miss traveling freely, even just to go out to dinner. I miss being able to sleep through the night without having to let him out or feed him. He is about 14 years old, too.
What makes this worse is that Bill has to go away again this week. I think Arran will be okay, but the new swollen lymph node gives me an ominous feeling.
On the bright side, he’s still eating and able to jump on the bed by himself. All he has right now is a little trembling and a swollen node. But I think it’s time to prepare for the inevitable. And here I was thinking, before I found that swollen node, that maybe we could get him one last dental. He definitely needs one.
Anyway, if you can spare some good vibes, I’d appreciate them. I just want it to be smooth sailing until the end.
As I wrote on my main blog yesterday, I was kind of dreading yesterday. When we still had Zane, I took him to the vet all the time for allergy shots. It got to be quite a grind, which I found kind of nervewracking. That was when we still lived near Stuttgart, and our vet was a several miles away. It wasn’t a big deal to drive there, obviously, though I don’t do a lot of driving anymore. I’m not sure why I’m like this now. Before I got married, I used to drive all the time. But then I got sucked into this stay at home wife gig, and I don’t get out much anymore. It’s not because I can’t go out, though… more like I choose not to. So, having to drive Arran the very short (even shorter) distance to the vet is kind of anxiety producing, especially in the COVID era.
I made a point of not getting to the vet too early yesterday. Noyzi demanded a walk, so I gave them one. Then I put Arran in his “seatbelt” harness and loaded him into the Volvo. Ordinarily, I would have driven my Mini, but it’s parked in the garage, and accessing it would mean moving the Volvo out of the driveway and getting my car out. And while Arran fits fine in the tiny back seat, getting him in the car when he’s mobility challenged, and there are only two doors, isn’t that easy. It’s a lot simpler to put him in the Volvo, since he doesn’t have to crawl over the driver’s seat to get in the backseat. I no longer have the upper body strength to simply drop the top and put him over the car door. There’s also a concrete barrier on our driveway that makes it harder to access the backseat.
We got to the vet at about fifteen minutes before our 11:00am appointment. I picked up a beeper from the receptionist and sat in the car with Arran until it went off. It was noticeably chillier this week than it was last week, although the skies were as overcast. Arran slowly ambled into Haus B, a part of the vet clinic I had never been in before. Arran’s regular vet wasn’t in this week, so another vet gave him his treatment. I liked her. Weirdly enough, she kind of reminded me of Mick Jagger. No, not necessarily because of her looks, but more in the way she carried herself. And her face and coloring bears a slight resemblance to his. I know that’s a weird observation, but I don’t mean it as a put down. I think Mick Jagger is an amazing force of nature! Anyway, she seemed somewhat easier to talk to, and less rushed. I don’t really know the vets at our office well, because Bill is the one who usually takes the dogs. But since Arran is getting chemo, I guess I’ll be getting to know them better.
The vet drew some blood to make sure Arran would be medically able to tolerate the chemo. After a few minutes, she showed me the results. Arran’s red blood cell count is still low, but his reticulocytes– immature red blood cells– are on the rise. That means that his body is responding to the anemia and making more red blood cells. In the meantime, “young” cells are being released into his bloodstream. This is a good finding, because it means that his bone marrow is still functioning and trying to repair itself. If there weren’t more reticulocytes being released, that would mean his body wasn’t responding and had “given up”– aplastic anemia. I’m sure in the short term, it would mean he’d need a blood transfusion and in the slightly longer term, it would mean he was on his way to the Rainbow Bridge.
After the happy news that Arran’s regular vet’s fear that his bone marrow was irreparably damaged (she had communicated this in an email to Bill) was incorrect, Arran got his second IV push of Vincristine. Haus B is a slightly less “house like” environment than the main office is, so I sat in an area next to a window and watched as many people brought their dogs for treatment. Dr. Konrad Blendinger, the man who, with his veterinarian wife, owns the practice is a vet who does highly specialized reproductive medicine for dogs. He mostly only sees dogs who are being bred, and it looked like some of his patients were waiting for him yesterday in Haus B. It was the first time I’d ever seen him in person, although I have seen him performing music in locally produced videos. I’ve noticed that part of German culture is having hobbies, and music is apparently one of his! We have that in common.
Arran was pretty calm during the chemo. He laid on his side and took the drugs like a champ, only managed to pull the cap off the port, which wasn’t a big deal. The female “Jagger” vet expressed mock dismay, then covered up the port until she was ready to administer the medication. After an hour or so, we were finished, and I loaded Arran into the car, asked for a bill (which wasn’t yet ready), and drove home. Bill came home a few hours later, and they had a lovely reunion!
Arran has responded very well to the treatment so far. His lymph nodes have gone down; he’s stopped coughing and gasping; his poops are mostly very normal; and he’s eating like an Olympic athlete. He still can’t jump on the bed, but he clearly feels much better. We still don’t know how much this will cost, but it’s been so nice to see Arran behaving more like himself. To be very honest, I think if we hadn’t started treatment last week, he might not be here today. The disease was definitely starting to progress. My main goal was to make sure Arran wouldn’t die without Bill– his favorite person– by his side. Now, it looks like that will be what happens, but we aren’t sure when. But then, that would be true for anyone, wouldn’t it? As this week’s events in Ukraine have shown us, one never knows when death will occur.
Anyway, we’re just going to enjoy this time, and do what we can for our sweet Arran. I think this experience will teach us a lot, not just about canine cancer, but about cancer in general. The drugs he takes are the same as what many humans take when they have cancer.
Not to leave out Noyzi, below is a video I made of him reacting to The Handmaid’s Tale, as Serena had her baby. He was very curious and empathetic. Noyzi is a true gentle giant.
And a couple of photos of our regal Kosovar rescue, Noyzi, who is now living his best life in Germany. He sure has come a long way!
Before I get accused of posting “clickbait”, I want to make it clear that this post is not about Bill or me. It’s about our elderly beagle mix, Arran, who was recently diagnosed with B cell lymphoma. I’ve been posting up to the minute updates on my main blog, but I wanted to post here for those who hit this blog because they’re specifically looking for information about life in Germany. I have a very different “audience” for this blog, although it seems like most of my readers come here to read about our trips to the nude spas. 😉
A week ago, I posted about how we were trying to arrange chemo for Arran to treat his cancer. Originally, we thought we’d rather just make him comfortable, because he’s already about 13 or 14 years old. We thought the vet would just prescribe prednisone or prednisolone for him, to help ease the symptoms of the lymphoma. For some reason, the vet said they didn’t usually do that. Then I noticed that Arran didn’t seem ready to go to the Rainbow Bridge. He was still pretty active, and B cell lymphoma supposedly responds to treatment better than T cell lymphoma does. I was also curious about canine chemo, since Arran is our fourth dog to have cancer and our second to have lymphoma. Our first lymphoma casualty was Zane, who died just one week post diagnosis.
Bill finally got ahold of the vet on Monday, and she ordered the necessary drugs for Arran. He’s been at Grafenwoehr all week, on a business trip. He will be gone again this coming week. I was very worried that Arran would get much sicker and die while Bill was gone. Everything I’ve read on the Internet tells me that Arran should have already died by now. But, as I’ve explained many times, Arran is a real fighter, and he’s not ready to go yet.
I brought Arran to the office on Thursday at 3:00, but had to stop by on Wednesday to get analgesics for him, as his lymph nodes had gotten so large that he was having trouble moving without pain. In Germany, COVID restrictions have been relaxed almost everywhere, except in doctors’ offices and other healthcare delivery facilities, and on trains and busses. So when we arrived on Thursday, I had to wait for the clinic to open, then get a beeper and wait outside to be called. I was the first one there, because I really wanted to get the appointment over with. I hate afternoon vet appointments. I find them exhausting. I’d rather go to the vet in the morning, so it’s done. When we had Zane, I was constantly taking him to the vet for allergy shots, so this is a familiar routine for me, except for the face masks, which are still required in doctors’ offices.
Arran went into the exam room and the vet quickly put in a catheter, then drew some blood. She later told us he was a bit anemic, which was concerning to her, although not all that uncommon for lymphoma patients. She told us to bring him in if he was in pain, short of breath, or had pale gums. Then she administered the first of several syringe vials of diluted Vincristine, which is a chemo drug. She explained the rest of the protocol to me and even printed out a schedule. Arran will come back for another dose of Vincristine on Thursday of the coming week. At home, he will get Prednisolone and Endoxan (known as Cytoxan in the US). The Endoxan is a chemo drug in pill form, and I’m supposed to wear gloves when I give it to him, and when I clean up his waste.
The vet asked about my schedule. I told her the only thing we have planned is for November 16th through the 20th. The 16th is our 20th wedding anniversary, so we are planning a trip to Ribeauville, France. The dogs will be coming with us. We have been to Ribeauville a bunch of times and have stayed in the apartment we rented several times. The owner is very dog friendly, so I feel comfortable in going there with the boys. I don’t care if we just sit there and drink wine and eat macaroons and madeleines. I would have liked to have planned something grander for the occasion, but there will be time for that later, when the chemo sessions are over. The effects of chemo, unfortunately, are temporary. But they will hopefully buy us some time.
After the first dose of Vincristine, we moved to an infusion room– a tiny little booth with chairs and an IV stand in it. It looked like the room had been built on to the side of the building, as there was a sconce on the wall that was obviously originally meant for outdoors. I thought maybe Arran would get an IV bag, but they used more syringes. It was surprisingly easy.
About an hour later, we were finished, and Arran culminated the treatment by releasing a rancid fart. Thankfully, the tiny room had a window in it. The receptionist said we could pay next week, since the vet had to ask the owner of the practice how much the treatment would cost. We aren’t too concerned about the money, because vet care is cheaper here than it is in the US, and because we actually have the money to spend. Living in Germany has been surprisingly lucrative for us.
When we got home, Arran, who had been obviously ailing before the appointment, actually wanted his dinner. Much to my surprise, he willingly ate kibble for the first time in over a week. I had been giving him chicken all week, and he’d had a little bit of bloody diarrhea. I was a little worried about how he’d handle the chemo, but he just ate his dinner and went to bed. I had put a blanket on the floor, and he made a bed and fell fast asleep.
At about 1:00am, he woke me up, because he needed to pee. I let him out, and he wanted a snack. I gave him a little more kibble, and we went back to bed until 4:00am, when he needed to pee again. Then, at 6:00am, I got up and made coffee. Both dogs came down to the kitchen for their breakfast. Again, this was a change, because for the past few weeks, Arran has been increasingly reluctant to rise in the mornings, and hasn’t been wanting to eat his breakfast. But on Friday morning, it was like old times. Because it was raining, we didn’t go for a walk yesterday. However, he was obviously feeling much better. His lymph nodes shrank noticeably, and he was eager to eat. He never managed to jump up on the bed by himself, but he didn’t cry when I helped him up, as he did on Wednesday.
By Friday afternoon, Arran was looking really good. All week, he’d been waiting in the foyer, hoping Bill would come home. Bill has been away on business all week, though, so Arran would be left disappointed. Last night, Bill came home, and I got a video of the reunion. I would say it was worth the price of the chemo for that alone. If you look carefully at the featured photo, you can see that Arran’s lymph nodes in his hind legs are swollen. Those nodes have now shrunk significantly. One is no longer detectable, and the other is about half as big as it was. I gave him more Endoxan and Prednisolone today. These are the same drugs often used for humans, but in veterinary medicine, they are given in much smaller doses. The goal is preserve quality of life, rather than curing the disease. Even if we cured Arran, he’s old enough that he could die of natural causes, anyway. So far, we haven’t observed any truly bad side effects from the drugs, although they can and do cause side effects for some dogs.
There is a high speed animal hospital near us called Tierklinik Hofheim. I’ve mentioned it a few times, and we have used it for Zane and Arran, although Noyzi hasn’t been there yet. They have an oncology department. If Arran had a more complicated case, or was much younger, I’d probably take him there for treatment. They have the ability to get test results faster than our regular vet does, and they no doubt have a lot more experience with treating cancer. But, again, Arran is already an old guy, so we’re not inclined to be heroic. We just want to get him to a point at which we can both be with him when he’s ready to shove off of the mortal coil. If he can make it to January, and celebrate ten years with us, that would be icing on the cake. Many dogs who get chemo for B cell lymphoma survive for a year. I’m not sure that will happen for Arran, due to his age, and the fact that his treatment was a bit delayed.
I’m not sure if we have any plans for the rest of the day. The weather is pretty crappy today. It’s raining, although it’s not cold outside. So this will probably do it for today’s activities… I’ve already spent time on the phone talking to USAA again, because they declined a charge Bill and I both tried to make to pay for Ribeauville. Calling USAA is always an annoying experience, especially since the lady I spoke to answered the phone as if someone spiked her oatmeal with crack, or something. But, as I’m writing this, the doorbell rang, probably with the latex gloves I ordered. Arran barked, and hurried down the stairs, as if cancer had never darkened his door. So I’d say that so far, Arran is doing very well. It’s very nice to see!