Health

German style chemotherapy!

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.

What a change! This was taken last night. He’s obviously feeling a lot better.
He was so happy to see Bill!

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!

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Our Heidelberger Birthday Holiday! Part six

Yesterday morning, we enjoyed another “lie in”, then packed up everything for the relatively brief trip home to Wiesbaden. I’m glad we went to Heidelberg. It’s not far from where we live, but it has a different feel. It was nice to leave Hesse, even if we were just over the line. I could have used another day, to be honest.

I didn’t take pictures of yesterday’s breakfast, which was much like the one before it, although we had it inside instead of out in the courtyard. I mentioned that it was my birthday and was hugely surprised by a special gift from the kitchen…

This was a delight! I truly wasn’t expecting it.

After breakfast, we brought our own bags down to the reception desk. They greeted me with a “Happy Birthday!”, having noticed it on the paperwork. All told, our extravagant weekend ran us about $2000 or so– including two nights in the junior suite, a couple of trips to the bar, breakfast, parking, one dinner, and a couple of bottles of wine. Yes, it was very expensive, but we felt it was well worth it after such a difficult and strange year. For us, personally, it wasn’t as difficult as it’s been for a lot of people… but it was definitely weird. I’m hoping for better and less odd days in the near future, as more people get vaccinated against COVID-19. We choose to enjoy life while we still can… and splurge when we can. Bill’s latest TDY per diem will be paying for this trip.

Since we couldn’t pick up the dogs until 6:00pm, we decided to go home a different way and spend a couple of hours in Speyer, a town in Rheinland-Pfalz I had heard a lot about but never had a chance to visit. On the way there, my German friend shared this adorable happy birthday video with me.

Bwahaahahahaaha!

After we parked the car, we started walking toward the picturesque city, when I spotted this…

We decided to just stroll through the town and take some photos, since we were really full from breakfast. Founded by the Romans, Speyer is one of Germany’s oldest cities. It’s the kind of place where it’s just cool to be there. It has a unique look and a different vibe. After our brief look, we’ll definitely have to go back for another visit and perhaps an overnight or two. Parking was cheap and easy in a huge lot near the downtown area.

After an emotional visit to the Dom, we strolled through the park, where there was a small fest going on. I kind of wanted to hang out for awhile, but Bill only paid for two hours of parking. Bummer… we will have to go back. This cute little festival was a nice reminder of what was, and what hopefully be again. Gotta keep the faith.

The dog was enjoying watching the kids on the ride!

We got home in the afternoon, just enough time for me to start the laundry and this travel series. We picked up Arran and Noyzi at the Tierpension Birkenhof 6:00pm. I could hear Arran all the way out to the car. He has a very distinctive bay! I’m happy to report that the boys did fine… When the caregiver opened the gate, Arran came right out to us.

Noyzi needed to be redirected. I’m glad to see he enjoyed his accommodations at the Tierpension Birkenhof!

Noyzi got confused and went back to his “room”. It actually took some convincing to get him to come out to us. Both dogs said goodbye and were relaxed and happy as we loaded them into the Volvo. I felt good about that. I didn’t expect Noyzi would have any trouble and he didn’t disappoint. I think the lady who watched them fell in love with Noyzi, which doesn’t surprise me, either. He’s a very sweet, gentle, easy to handle dog.

Arran says hello before he had his accident in our backyard.

My birthday would have ended up on a great high note, if not for Arran’s exuberance when we got home. Once we let him off the leash, he took off running outside. At some point, he must have careened under the bushes at a high rate of speed. He and Bill were having a reunification bonding session when I noticed blood on Arran’s shoulder. I took a closer look at the fresh wound and realized that he’d torn a big gash open, with a flap hanging down. It wasn’t bleeding a lot, but it was kind of deep.

So poor Bill had to take Arran to the Tierklinik Hofheim for debridement and stitches. Sadly, a lot of people were having pet emergencies last night, so although Bill got there at 9:30pm, he didn’t get home until 4:30am, about 825 euros poorer. The vet clucked sympathetically over the cost, which was pretty high… but in the United States, it would have cost a hell of a lot more than 825 euros to get emergency stitches for our dog in the wee hours of the morning. So while we wish the accident hadn’t happened, we’re grateful the clinic was available and Arran’s situation wasn’t worse. Bill said he counted three people who lost their pets last night. 🙁

Arran seems no worse for wear today, except for the stitches. They loaded him up with antibiotics and painkillers, and I suspect the forced rest will cramp all of our styles a bit. He jumped up on the bed at 4:30am, gave me a kiss, and went right to sleep. He’s been napping all day today. We’ll be taking the hedge trimmers to that bush in the backyard. This is the second time Arran has cut himself on it.

Well, that about does it for my birthday celebration for 2021. If you’ve been following along, thanks so much for reading. We really had a great time. I guess if there’s one thing we’ve learned from the pandemic, it’s that travel is a wonderful privilege that shouldn’t be wasted or taken for granted. And every once in awhile, it’s a good thing to splurge. I suspect our next splurge will be when we book our long awaited dentist appointments in Stuttgart. That will probably be next on the agenda… and after that, maybe a real vacation! Dare to dream!

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