B Cell CLL
Tomorrow Sweet Bree goes in for her one month blood test. She is doing great. The bleeding is reduced in the past week, knock wood, She still doesn't want to leave the yard for a walk, I bribe her with small treats and when a friend comes with his doggies she will walk a mile with them...she makes sure we don't take the longer walk. She still loves the Bark Park...she might be ready to go home a bit earlier than she used to but hey she is 11 years old.
I am going to tell the Vet the drugs that your puppy is on with the BCell CLL. I do hope the steroids will be reduced from the 20mg..Poor thing doesn't sleep she is up all night...and keeps me up. I now know how parents of newborns feel when they are sleep deprived. Basiclly Bree is still my Bree...happy...and HUNGRY. I think she is gaining weight more from not walking as the increase in food is with fresh veggies...two heads of cauliflower a week and 2 dozen sprouts. Okay I eat some of the cauliflower at snack time. *giggles*
I should have her blood work results next week so I will check back then.
Many hugs for you and your puppy.
Bell & Bree
The Leukeran + Prednisone is the standard CLL treatment. Some CLL dogs can readily be weaned off the Prednisone, with only the Leukeran required to keep it in check. Mine needed the Prednisone as a help drug for the Leukeran. The first month blood work showed a drop of WBC from 220K to 32.5K with 75% of the reduced number still being Lymphocytes. Buried in the lymphocyte count are the cancer cells. The results can be dramatic in the first month. For yours, the platelet count will be interesting.
Unless your dog had past kidney/liver problems, or hip/weight issues, you might want to get a high protein/fat doggy food to satisfy the hunger. Mine was already on a 28% protein/15% fat doggy food at the point of diagnosis. The same brand and formulation throughout his life. I increased the amount by 20%. No time for diets or weigh control when cancer is involved. If the diet is protein deficient the cancer cells will take what's available, with the body having to break down muscle and tissue/organ protein for its needs. Yes, he has gained weight (67-->74 lbs). Mostly in the form of fatty or lipoma tumors. But that's better than losing weight, and losing muscle mass. Abdominal muscle loss is also a side effect of Prednisone over time.
At 9 months post diagnosis he's less energetic, and doesn't like the muggy hot weather outside. Still on Leukeran plus 10 mg Prednisone + 20 mg Prilosec. His Aug WBC count was 16K, absolute lymphocytes 652 or towards the low side. Supplements of 3000 mg/fish oil per the 2 meals. Vitamin D 800 IUs with the evening meal. Only problems recently encountered was when he sampled some free food in the woods, and gulped down deer beanies or something that caused diarrhea. Probably has been doing it all his life with no effect. His compromised immune system can't prevent bacterial/protozoa over growths.
He sleeps well at night. Sleep problems are reserved for his older sister, or my Vestibular Syndrome dog. Who sleeps all day, and paces all night long.
The evil cell count is way down. It had been at 35k now at 1k. Happy Dance time. Still a bit anemic but even that is improving. The Vet approved the fish oil and vitamin D. I will check her protine level on her dog food. probably light as it is a senior dog food. We are backing the prednisone down to 15 mg. I had found a study going on at Colorado state and mentioned it to my Vet. He said once they found it was Bcell CLL they sent all of her records and will continue to do so. I am so happy her numbers came down fast. She has no digestive problems with the chemo or steroids which is good. She also hasn't had a nose bleed in a week. (knock on cute puppy head)
Bree hasn't been following her nose like she used to and also used to add wild droppings to her diet. She is deaf so her sense of smell is like a beagle. The heat I am sure is a factor in her short walks and I can't wait for fall to see if this changes. She still loves her trips to the bark park but does slow down faster than before, but Tuesday she almost ran after a tennis ball..a real scurry!
She knocked over the bathroom trash for a paper towel...I won that round. Now the bathroom trash lives in the tub.
Feeling very hopeful.
Thanks again,
Bell
It helps you caught it when the count was only 35K. Mine was anemic initially, and currently low end normal for RBCs, and hematocrit. The amount of recovery with time, being related to the amount of damage initially done to the bone marrow by cancer cell infiltration. It takes a few months to see how far the RBCs, and platelets will correct to.
Hopefully over time the Prednisone will be withdrawn for yours, with just the Leukeran being given. Mine was at 20 mg for months. One liver enzyme sky high. Without looking believe it's ALP. A side effect of the Prednisone.
Keep a watch for any infections. If puppy dog becomes nauseated, take the temp. Organic dropping are off the menu. Although mine will still try to sneak in a snack. I keep a supply of Metronidazole at the ready for the next bout of diarrhea, just in case he munches on something.
A 50 yrd walk in the morning wears my CLL puppy out. But he seems content, happy, and ... Hungry. Only time he runs is when I tell him I have a treat for him.
Yesterday her stools were first loose then liquid. She is almost half way on changing her dog food over to high protien, I have been doing this slowly over the past few weeks. Then last night she vomited. First time in the 3 years since I adopted her and she insisted on going outside to do it. She hasn't been snuffling on her outings since she got sick so she hasn't been trying to eat things out doors. Should I follow protocol for a normal dog, withhold food for a day then chicken and rice until her pooh is normal? I have her on a half dose of Metronidazole as she has IBS so I will increase it back to full.
I will take her temperature. I worry about withholding food where she needs to take her drugs and I have always given them with a small meal.
Good news. Twice this week she has walked without bribes or her friends so that was a reason to celebrate.
I would have the Oncologist check her. Where the Oncologist would look for evidence of a "Blast crisis", characterized by a surge of lymphocyte "blast" cells. CLL can suddenly, and without warning progress to an acute phase in some dogs. Vomiting, diarrhea, and temperature are all clinical signs. Of course the same signs can point to infection. So if the Oncologist says nothing is happening, then you have peace of mind, and can progress to treat it as an infection, and/or treat the symptoms.
Mine had the liquid diarrhea that shot a foot out of him, but no vomiting. I was amazed he could hold it to get outside. I treated with Immodium A/D (Loperamide) giving a full dose, and then 1/2 dose at night. Consult with your Vet. Some Vets fear toxin build up from the Immodium. In addition Metronidazole, and Endosorb (soaks up bacterial toxins) tablets were given. Again, mine did not have the vomiting along with the diarrhea. The Vet will likely prescribe Zofran (Ondansetron ) if the vomiting continues and/or the dog stops eating. Their favorite drug is the more expensive Cerenia.
You can give the Leukeran, Prednisone, and Prilosec wrapped in melted cheese balls. A sticky alternative is inside peanut butter. You don't want to interrupt the Chemo, unless the Oncologist tells you to do so. Mine was taken off Chemo to recover from an April infection, and his lymphocytes started to soar in a matter of days.
My Chemo puppy is 2 months away from celebrating (???) the anniversary of his CLL diagnosis. He tires easily. But he's happy, and content.