Maverick
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Journal

* Note: This information should be used as a reference only and not as medical advice.  This outlines the treatment course we used for Maverick and may not apply to any other case.  Please consult with your trusted veterinary oncologist for medical advice pertaining to your case.  We are not doctors.


10/24/08

Maverick had an appointment today for his annual check up at Broad River Animal Hospital with Dr. Lamothe. As part of that check up we spoke again about a small bump/ pimple type thing that has been coming and going for quite a while. The bump is on the top of his head towards his left side. Dr. Lamothe aspirated the cell and sent it for pathology. We also did a Superchem, CBC, and VA.

10/27/08

Dr. Lamothe called with results of the bump. It is being diagnosed as a mast cell tumor and needs to be removed. We talked about price, what the surgery entailed and also have some x-rays done and a teeth cleaning.

10/29/08

Maverick goes in early in the morning for surgery, x-rays, and a dental cleaning with Dr. Lamothe. We also had her aspirate three other small masses we were worried might be Mast Cell Tumors. The three masses came back as nothing to worry about. The x-rays came back fom his chest and abdomen totally normal and the x-rays from his chest showed a little arthritis. The teeth cleaning went really well as expected. The mast cell surgery went well. They removed the mast cell with an elliptical incision around the mast cell margins. The removed an area 2.5 cm by 3 cm and about 3mm deep. They stitched the opening closed really well.

When we picked Maverick up he looked just horrible and felt horrible too. He was confused, loopy, tired, uncomfortable, in pain, etc. You name it he felt it. We were so glad to have him home.

11/11/08

Returned to Broad River today to have stitches removed. While at Broad River I asked Dr. Lamothe to check three other little bumps that popped up since were at the vet last. The scrapings on the bumps came back as mast cell tumors. Dr. Lamothe recommended we go the VOHC (Veterinary Oncology And Hemotology Center). I went home and made an appointment for the afternoon with Dr. Hazzah and Dr. Post.

Dr. Hazzah and Dr. Post, myself, Howie and Maverick meet to discuss his history and the next steps. The Dr.’s recommend doing a proliferation panel to help us sub grade the mast cell tumor. We also talked about and agreed on doing a full staging for cancer including ultrasound, Bone Marrow aspirate, aspirate of lymph nodes, biopsy of the new mast cell tumors. We make an appointment with Broad River to have these tests done for tomorrow.

11/12/08

Staging from Mast Cell Tumor came back as a low grade mast cell tumor Grade II. Maverick goes in early in the morning for testing. During the testing which goes well Dr Lamothe finds another Mast Cell Tumor as well as a mass in his spleen and calls Dr. Hazzah over at the VOHC. Dr. Hazzah recommends not removing the new mast cell tumors and starting chemotherapy as soon as we get all the test results back. She also recommends aspirating the mass in the spleen.

Maverick returns home in the evening and is generally feeling lousy. He is super sore from the bone marrow aspirate which was done on his back left hip. We got him as comfortable as we could and waited for more news.

11/14/08

Results come back to our surprise as well as the whole veterinary team working with Maverick his lymph node aspirate and spleen aspirate show signs of lymphoma. But the bone marrow aspirate came back as lymphoblast leukemia. We all think there has been some kind of mistake including the doctors. Maverick is showing no signs of a sickness of this magnitude plus his bloodwork shows no signs. We are just in shock. Howie spends hours and days researching everything trying to make sense of all of this. I spend most of my time taking care of Maverick and babying him.

11/21/08

We went back to the VHOC today to see Dr. Hazzah. We had Maverick rechecked and discussed the case further. We spoke about the treatment and prognosis for both lymphoma and leukemia. We also discussed doing a flow cytometry which will help differenciate between lymphoma and leukemia. We decide to return on Monday to draw blood for Flow Cytometry since the cells might not live through the weekend. We also discuss our chemotherapy options. We discuss using Cytosar as it is effective for both leukemia and lymphoma. We will also begin Prednisone with the chemotherapy.

11/24/08

Today we have a appointment with Dr. Elpiner (another one of the doctors over at the VOHC). We draw blood for the flow cytomety and decide to hold off on starting chemotherapy until we get the results.

11/25/08

Dr. Elpiner calls with the results of the Flow Cytometry from NCSU (North Carolina Satate University). The test showed the lymphocytes in the sample range from normal in size to somewhat large. There are two populations of lymphocytes based upon CD45 staining characteristics. The first population is 50% are CD34+ which is consistent with an acute leukemia and are negative with other phenotypic markers. The remaining 50% of the cells in the first population contains a distribution of T and B lymphocytes. The second population are CD45 dim, consistent with blast cells, and of this population 65% are CD34+. This is most likely an acute lymphoblast leukemia based on scatter characteristics and positive CD34 staining, however an acute myelogenous leukemia cannot be ruled out.

11/26/08

We started chemotherapy today for acute leukemia. Immunohistochemical stains were submitted to try and further differentiate between lymphoid and a myeloid leukemia. Maverick begins a course of Cytosar which consists of 4 subcutaneous injections over 48 hours. Each injection consists of a saline injection, then a Cytosar injection (150mg each, totalling 600mg over 4 doses), then a saline injection. We learned to give the injection in the office so we can do it at home over the next two days. Maverick also starts Prednisone; he takes 30mg daily.

11/28-30/08

Went to Cape Cod and had fun on the beach with the dogs. It was great to get away with dogs and be in Cape Cod (one of our favorite places).

12/1/08

Dr. Elpiner called stating markers from the slides came back negative. So they are calling Maverick's disease now a undifferentiated acute leukemia.

12/2/08

Went to see Dr. Elpiner for chemotherapy and an oncology recheck. Maverick did his second course of cytosar this time 585 mg. We also started a course of an antibiotic Zeniquin 100 mg tablets once daily because his white blood cell count went to 1.3 (too low to be comfortable not having him on preventative antibiotics).

12/8/08

We have an appointment with Dr. Bergman at the Katonah Bedford Animal Hospital. We wanted to get another perspective on Maverick’s case. While at Katonah Beford we discussed chemotherapy options, the bone marrow transplant and decided to take blood to run a PARR test (which is the most precise, molecular level test available).

12/9/08

Today we had a oncology appoitnment with Dr. Post at VOHC. We discussed the pros and cons of a chemotherapy drug called Doxorubicin 29mg. We decide to go ahead with this course of action which is done one time in house.  They did an EKG (to get a baseline, as Doxorubicin has a small chance of being cardiotoxic), gave a Cerenia injection 30mg (the strongest available anti-nausea medicine) as well as 4 Cerenia pills to go home with (each is 60mg), and a Diphenhydramine injection (an antihistamine) 29 mg.

Today, we also started this website and posted the following plea for help.  Letters containing the same text were sent by the ACA to all registered owners of Maverick's littermates and half brothers and sisters.

To Whom It May Concern:

I need your dog’s help. I have a 6 ½ year old Weimaraner, Maverick who was just diagnosed with cancer, more specifically acute leukemia. The prognosis is very poor according to the research and our doctors are giving Maverick weeks to maybe 9 months to live. Acute leukemia can be somewhat managed with aggressive chemotherapy (which we are doing) but unfortunately it cannot be cured. But, there is one promising option which is why I am writing to you. Maverick can possibly receive a bone marrow transplant, which is NOT an invasive surgery for either the donor or recipient, that could potentially cure him. In order to receive this transplant, we must find a donor whose bone marrow matches Maverick‘s. This can be accomplished through a simple blood test performed at your veterinary office (which we will of course finance). The more dogs that are tested, the more likely it is that we will find a match.

You can read about this revolutionary procedure at -

Canine Bone Marrow Transplants at NCSU

Maverick is an amazing, super intelligent, and loving dog. He is a huge part of our family and we can’t imagine life without him. Right now, he is living an active, healthy life even with his cancer but it is unlikely that this will continue for long given known veterinary data. Now is the best time for us to attempt this procedure because if we wait too long and he becomes ill, he may be unable to handle the transplant. Time is of the essence.

We created a photo gallery of Maverick with the rest of our family. Please take a look if you get a moment!

Maverick's Photo Gallery

Please, as one dog lover to another, help us by having your dog tested. I am available at any time by phone or e-mail to answer any questions or concerns you might have, as well as to of course coordinate the quick blood test we desperately need you to help us with.

I look forward to speaking with you as soon as possible. Thank you so much in advance.

Sincerely and Gratefully,

The Altman Family


12/10/08

Today we went for another opinion at the Animal Medical Center in the city. They looked over the file, agreed with the course of action we are doing and that was about it. But we are still glad we explored all these options.

12/16/08

Saw Dr. Post today and gave Cytosar. All other meds stayed the same. We further discussed a bone marrow transplant.

12/19/08

Maverick made it onto his first blog!

http://dogstarranch.blogspot.com/2008/12/tis-10th-day-of-christmas.html


12/23/08

Dr. Post is away so we saw Dr. Hazzah. She gave Doxorubicin this week and sent me home with Cytosar next week since we will be away RV'in.

12/24/08

We planned a week and a half RV'ing trip with the dogs to get them and us somewhere warm!  It will be our first RV trip!

http://www.cruiseamerica.com/

12/25/08

Christmas Day: Since we do not celebrate Christmas we spent much of the day cuddling in bed with the doggies. When we did finally get up we took them to Cranberry Park in Norwalk. We were just about the only ones there. It was a lot of fun running, chasing, and playing catch especially because there was still snow on the ground. Maverick and Ruby love the snow. We decided to end our visit early however because Maverick's paws were hurting from the cold.

12/26/08

Today, we found one of Mavericks sisters, Mia Garcia. Mia’s family has so generously decided to get Mia tested to see if she is a match. Hooray! There is a 1 in 4 chance that she is.

We picked up the RV for the impending road trip. Maverick and his sister at first sight barked at the huge vehicle but then when there daddy opened the door their tails started to wag. They hopped inside without coaxing and explored every area, sniffing and sniffing away. There was a lot to smell but they really seem to like it. Maverick likes the bed and the driver’s seat and Ruby likes the loft and the table. We will have to work on her not hopping up on the table. She would never do that at home.

12/27/08

We had a big Chanukah party, lots of family and friends. Maverick really enjoyed visiting with all the people he loves. Most notably the grandmothers and our three year old cousin Maggie. He cuddled and kissed them. He was so excited to see them and be with them. And Maverick truly enjoyed all the delicious holiday food. He was also feeling really well that day.

On another note, I accidentally gave Maverick his Zeniquin and Prednisone in the morning rather than the evening. This accidental early dosage seems to have alleviated Mavericks urinary evening discomfort. We will continue to medicate in the morning and see what happens.

12/28/08

Today, we went Rvin’. It took along time to get packed and both dogs seemed excited and hesitant. We got a very late start. And drove many hours through the night to make it to Stafford, VA. The beginning of the ride was a little scary for the dogs. The RV is very big and rattly and the doors and cabinets open and close on their own. But soon the dogs got a handle on it. Ruby had a much easier time than Maverick. Our first night in the RV was fun though. Ruby slept up in the cabin in the passenger seat the whole night. Maverick slept on the bed with us under the covers. I guess he was cold.

12/29/08

Today was a very exciting day, not only was it our second day Rvin’ and certainly by day two we were all much more comfortable but also we took a little side trip to The University of North Carolina to see Dr. Suter. This is where Maverick will have his bone marrow transplant and Dr. Suter is the doctor who will be performing the procedure. Maverick really liked seeing and kissing Dr. Suter. For me and Howie is was nice to see the facility and talk face to face with Dr. Suter prior to Maverick’s procedure. We also got to see the current bone marrow transplant, Dusty who was one day away from going home. Dusty looked healthy, happy, and very well cared for. So far this was the best part of the trip.  

12/30/08

Today, is the first day of chemo for Maverick this week. In order to give him chemo we must have a CBC done to be sure he is healthy enough to receive chemo. So, we went to and emergency clinic in Durham, NC and had his blood work done. Maverick's blood looked pretty good, just about the same as last week, so we went ahead and gave him chemo. Maverick is much more comfortable with the RV now. He likes to sit on the banquet/couch behind the drivers seat and look over the driver’s shoulder. He also likes to sit in the captain’s chair and cuddle up like a ball. I would have to say his favorite seat of all is shot gun. He likes looking out the window and feeling the breeze on his ears.

We also received an e-mail from Dr. Suter today telling us that Maverick's bone marrow transplant is currently scheduled for January 23rd, Howie’s 30th birthday. Maverick’s health is the best birthday present we could ever ask for.

12/31/08

We woke up today at a gorgeous RV resort in Hilton Head Island, South Carolina. The sun was shining, the waves were crashing and we all felt happy and healthy especially Maverick. What a change. So, we are currently getting us and the dogs ready to head out to a doggy beach about four miles away. This will be the first time they will be able to run around since we left on our adventure.

The other thing that is exciting is happening is the sibling that we found of Maverick, Mia has an appointment to get her blood drawn for the matching test this coming Monday. We are so thankful to the Garcia family for their help.

Also it is a very Happy New Year. Maverick is doing fantastic and we are very hopeful he will continue to do well. We are so thankful to everyone who has helped with Mavericks care in the past few months. Also thank you to everyone for their prayers, calls, e-mails, etc.

1/1/09

It was colder today around 35ish in Hilton Head. So we spent much of the day in the RV resting, watching Netflix and cuddling with the dogs. They are so at home here now. They really seem to love it. Around 3:30 we went to the doggy beach. We were just about the only ones there due to the chilly temperatures. But that didn’t stop the dogs from enjoying every inch of the beach. They played in the sand, on the dunes, in the tall grass, and of course in the water. It was so much fun to watch but also quite chilly.

We also were contacted by someone who has a Weimaraner from Happiness is Pets. His name is Mike and he has two Weims Izzy (from Happiness is Pets) and Smokey (who unfortunately just recently under went surgery for bloat). Smokey - our prayers are with you, we hope you make a full and speedy recovery. So we are going to find out if Izzy is a sibling of Mavericks by contacting the ACA (the American Canine Association). If Izzy is a sibling, then we will test her to see if she is a bone marrow match.

Last night Maverick had a little bit of a rough night. For the first time in over a week, he wet the bed. Of course this is still because of the prednisone. But he tries to clean up the peeing by liking the sheets until they are soaking wet. He wants his sleeping area to be clean but he has no control over it. And Howie and I know that Maverick doesn’t know that. Other than the little accident, Maverick is feeling great. He finished his chemotherapy for the week with no reaction.

1/2/09

Today is a beautiful day in Hilton Head Island. Warm and sunny just a perfect for a last day of vacationing without any driving.

In terms of Maverick’s Bone Marrow stuff today we will call the ACA to find out about Izzy’s pedigree. We will call Leslie at Naperville Animal Hospital. Leslie has been trying to look through their computer system in order to search for Weimaraners from Happiness is Pets. Naperville Animal Hospital has a contract with Happiness is Pets to give their animals veterinary care. So when Maverick was purchased we had a free visit at Naperville Animal Hospital. Our assumption is Maverick's Weimeraner siblings also went for their free visit to Naperville so they should be in the system too. We are also going to call Christian today from Happiness is Pets. Christian was going to try to search the system for other Weims they have sold in the past. So far they have been unsuccessful.

Leslie was able to search their database by birth date. She came up with four hundred dogs with the same birth date. She printed all the dogs out and will bring them home and look through each one to see if they are Weimeraners. She has been so helpful throughout this whole process. We really appreciate it. We also spoke to the ACA and unfortunately Izzy is not a sibling to Maverick but we really appreciate Izzy and Matt's help. In terms of Happiness is Pets we are still struggling to get the help we need. Christian is no longer working for Happiness is Pets, his brother Justin is now the man in charge. But so far we haven’t been able to get in touch with Justin. However we spoke to Karen the acting manager and she said she will pass the message along to Christian and Justin. She will also search through the computer and see what she can dig up.

The only thing is we are running out of time with finding a match. We have three weeks or so to the procedure date. In order to find a match blood has to be taken, sent to Washington State to Dr. Sullivan then to Pennsylvania to Dr. Wagner. Dr. Wagner will then test for matches. If we have a match, we will have to convince the owner to have their dog be a bone marrow donor and come with us to North Carolina for the procedure. The other option is that at this point, since Maverick is doing so well, they can probably harvest his own bone marrow. However, this will only work if he is in a clinical remission (meaning there are no or nominal signs of cancer in his blood or bone marrow). We just continue to pray that we will be able to do one of the options.

So today is our last official vacation day, so we spent the whole afternoon at the beach. It was great. The temperature of the air was nice and warm. Although the water was very chilly. The dogs swam, ran, chased, etc. for hours. Perhaps we over exerted them because by the end of the afternoon they were both so exhausted they were struggling waking up the two steps to the RV. Also as soon as Maverick stopped running and swimming he started getting very chilly, he was shivering and his teeth were chattering. So we got him dry and warm quickly. He and his sister slept for the entire rest of the evening and night except for going to the bathroom. Maverick unfortunately had several accidents throughout the night, due in large part to drinking so much water while swimming.

1/3/09

We are getting ready to leave Hilton Head Island in just a little while. I think we are all sad to leave and not quite ready for vacation to be done. Howie really wanted to go to the beach again this morning but the dogs are still so tired from yesterday and we need to get on the road. It is a 14 hour drive home. Our plan is to drive 9 hours today and stay at the same camp ground we stayed at on the way here in Stafford, VA. It was really nice and it is in the same town as where Ruby’s breeder is from. Tomorrow we plan on stopping by the breeder and seeing Ruby’s mother, Jenna, before heading home.

The hardest part about heading home is we have a lot of stressful things ahead of us. Tuesday Maverick is having his Bone Marrow, Flow Cytometry, PARR, and CBC retested. The results of these tests will determing if Maverick is well enough to have the transplant done. We also have a lot left to do in terms of matching Mia and also trying to find anymore sibling matches. On top of all that we have the normal stresses of getting back to work and normal every day life after a vacation. We also have three weeks before Maverick's scheduled transplant. There is a lot to do, a lot to plan, and a lot to think about. And I am sure the next three weeks will absolutely fly by.

Maverick has been extra cuddly on the ride home today. He has been cuddling couch with his sister, putting his head under our arm while driving and sitting on the lap of who ever is sitting in the passenger chair. So cute, but he is really too big for a lap dog.

1/4/09

Today we are on the last leg of the journey home, five hours of driving left. I think we will all be glad to sleep in our own bed tonight. Maverick woke up feeling really great. He had what I always call a pep in his step. He just seems to be feeling good. He was playing with his sister and running around without being coaxed into it. It is really a pleasure to see.

We are getting ready to go to Southland Kennels to see Ruby’s mommy, Jenna. I am really excited. Hopefully both dogs will have fun with all the labs.

The dogs all had the greatest time. Running and playing with the labs. And the new puppies were so cute. I am so glad we went.

As soon as we pulled off I-95 in CT, the dogs became super alert and excited, knowing we were almost home. The loved playing and eating the snow on the ground and jumping on our bed. It was really sweet.

1/5/09

The hardest part about being home is not spending every moment with Maverick, Ruby and Howie. I think the dogs missed us too. Maverick and Ruby spent most of the day playing with our cleaning ladies and resting. I am glad Maverick has been resting, because tomorrow is our big day, we are retesting everything for the cancer.

This morning Mia, Maverick's sister went to have her blood test done. The doctor said she looked happy and healthy. The blood samples are on their way and hopefully will know if she is a match soon.

The only other thing that happened today is Ruby got her paw stuck in the crate. When I opened up the back door I heard I awful screeching, scream. Maverick and I ran up the stairs to Ruby’s crate as fast as we could and helped her get her paw out. It was quite frightening. She was in a little pain, but other than that she’s fine. Maverick has been babying her ever since, resting and watching her.

1/6/09

Today was supposed to be the big testing day, unfortunately Maverick ate breakfast and lunch and could not be sedated having eaten. We will have him fully tested tomorrow. We did still go ahead with our regular weekly oncology appointment. Maverick's lymph nodes have completely shrunk and his CBC was really good this week. All signs point to the cancer is gone. We will have to wait and see on the results from the bone marrow aspirate, the flow cytometry, and the PARR.

1/7/09

We had all the tests done. Maverick was a good boy during the procedure. He has been feeling well maybe a little tired and agitated. The hardest part about the procedure was not feeding him especially when you know he is so hungry. Luckily tomorrow he will be back on his normal eating schedule. We should hopefully have the results by Friday when Maverick goes back to the Oncologist.

Also, Howie, Dr. Suter, and Dr. Hazzah all touched base today on Maverick's treatment being that we are less then three weeks away from Mavericks transplant date. They decided Maverick should stop in the middle of this week's Cytosar treatment (so he received only 293mg instead of the normal 585mg this week) and receive his high-dose Cytoxan (500mg/m2) with Mesna and lots of Lasix this Friday, the 9th, and then start the Neupogen on Saturday the 17th.

Another exciting thing happened today we were contacted Tracey Peake, who works in the News Services office at NC State. Her office handles media relations for the university. Dr. Steve Suter sent them our email address so that she could contact us about the possibility of media coverage for Maverick's procedure. I am thrilled about this. We had actually tried contacting news sources about this story before. Plus I think Maverick would be great on camera or pictures.

1/8/09

Today was a very uneventful day. Maverick spent most of the day resting and relaxing from yesterday. The were some snow flurries in the middle of the day, he and Ruby enjoyed running around through the flurries and catching them in his mouth.

1/9/09

Today Maverick had a big day at the Oncology center. He had a high dose of Cytoxan as well as Mesna and Lasix. He peed for the first two hours almost constantly but then seemed fine. The only other change was mild lethargy. He also really just wanted to lay on the floor rather then the couch or bed.

We also got the results of the Bone Marrow and Blood work from Antech. The results were good overall, initially we were disappointed that they were not perfect and cancer free. But that is truly an unreasonable expectation. We are still waiting on Flow Cytometry and PARR results.

Today we received a call from a women named Evelyn who saw our flier and has a Weimaraner Zack, whom she rescued. Zack is about 7 years old so he very well maybe a sibling or half sibling of Mavericks. Evelyn said she would see what paper work she has for Zack. Howie will call the ACA to see if Zack is a sibling tomorrow.

1/10/09

Maverick is still feeling well today. We had a little scare last night when we realized his Lasix pills had expired but the confusion was all worked out this morning thanks to Maria (the computer pulled the wrong lot number when they filled the prescription). We really appreciate all her help. The plan for the day as well as the weekend is to stay home and relax. The Lasix are still making Maverick go to the bathroom a lot and with the bone marrow transplant so soon, we cannot risk anything. He just needs to rest and stay healthy. As for Howie and myself, I do no think we have ever been more tired and stressed in our entire lives. But of course, Maverick is totally worth it.

A big snow storm is supposedly headed our way. When it does snow I will definitely get the dogs out to play. They love snow, especially Ruby. Her new thing is laying in it.

Evelyn called back today to say she could not find any papers on Zach. Howie called the ACA but they were closed. Evelyn e-mailed us a photo of Zach. Zach is a near spiting image of Maverick so we decide to have his blood drawn to see if he is a match. They plan on doing this early next week.

1/11/08

Today we got up and it was a winter wonderland. Fresh snow or so we thought until the dogs were slipping and sliding trying to go to the bathroom. They didn’t seem to mind that much. While Howie was shoveling they were laying in the snow chewing on rawhides and it was so cute. Maverick also wore his new jacket for the first time in the snow.

We received an e-mail this morning from a woman named Brittany who has a weimeraner named Apollo. I love the name Apollo for a Weim by the way. Apollo is 9 months old, so most likely he is not a match. Also they are from North Carolina and I would assume most of the dogs are living in Illinois because that is where they were purchased. But we e-mailed her back to get some more information. Either way it is so nice that Brittany wanted to help, we really appreciate it.

1/12/09

Maverick seems to be feeling really well overall. He is still a little nauseous from the high dose Cytoxan. We are getting down to the wire in terms of his bone marrow transplant. We are planning to leave for North Carolina this Saturday. There is a lot of stress and worry on my end. But the most important thing is keeping Maverick comfy and happy.

Maverick is back on his normal medicines only. Zeniquin at 100mg once daily and Prednisone 30mg once daily.

Howie just spoke with Dr. Hazzah and she got the flow results which sound promising. She is going to follow up with the North Carolina State lab to understand what the normal CD34+ ranges should be. Maverick's results were 3.8% and 2.2% respectively.

1/13/09

I received an e-mail from Dr. Suter today saying that he wants to put Maverick on the lowest fat diet possible after starting the Neupogen. Waltham's LF is a good choice. Lipids in the blood really screw up the machine that extracts the stem cells, so a no fat or extremely low fat diet is essential before the leukaphoresis. Also, he thinks it would be prudent to do another bone marrow and blood PARR on Monday when we arrive to see if the Cytoxan and Elspar has further cleared the CD34+ cells and we agree.

Unfortunatlty, I was unable to find the Walthams LF so we are using the second best low fat food around, Hills WD. To intergrate the old food in with the new, we will give Maverick 1/3 new one day, 1/2 new the next, 2/3 new the next, and finally all new the final day to make the switch over.

1/14/09

Today when I woke up, I could tell by looking at Maverick he was not feeling well. When I called his name he did not get up, he didn’t even lift his head. When I went over to him to give him kisses, he did not kiss me back. Howie took his temperature and it was still in the normal dog range however it was more than a degree higher than his normal morning temperature.

Maverick and I made a trip over to the oncologist, luckily they are local and always willing to squeeze us in. Dr. Brodsky and Dr. Hazzah saw Maverick and took his temperature, checked his lymohnodes, and ran a CBC. The CBC came back with his white blood cell count very low, 1.7. That would explain why he did not feel very well. So the doctors decided to add Clavamax, another antibiotic, to Maverick's daily drugs as a further precaution.

We just got amazing, extraordinary news. Maverick's blood PARR came back negative. He is in a clinical remission!! We can go ahead with the Bone Marrow Transplant confidently. This is so exciting. We have been working towards this day for months now, I can’t believe it. Maverick has done phenomenally well through all this and we have been so lucky.

1/15/09

Maverick woke up feeling great, you could just see in his eyes whatever was making him not feel well yesterday had left his system. His stomach was a little upset between the extra antibiotics and the food change. After giving him his Clavamax, we also give him chewable Acidophilus. The acidophilus really seems to be helping and Maverick likes the taste of it. It is strawberry flavored.

Last night when we were ready to go up for bed after dinner, Maverick decided he needed to play. So we all played tug of war with a rope for a while. It was really fun, especially when it was Ruby vs. Maverick. We only played for a little while because we did not want to over do it.

1/16/09

I woke up today feeling stressed and overwhelmed. We leave tomorrow for Mavericks procedure at NCSU. After the dogs had their breakfast, they had their medicines and went out. I began baking cookies for the animal hospital down at NCSU, cooking up a lot of veggies and ground beef for Maverick for the next couple of days, made all of our hotel reservations for the trip and packing Ruby for vacation over at Oso Canine Country Club (a dog sitter locally - www.osoccc.com). I still have to take Maverick to his final Oncology Appointment, pack Maverick’s stuff, and pack our stuff.

I also received a message from Dave Green over at the Media & Communication Department at NCSU. He was calling to make arrangements for when two TV stations can interview us and Maverick. It is so exciting. We really want Maverick's story out there in the public, so we can help other dogs with similar health problems.

I just returned from Maverick's last pre-transplant oncology appointment. It was both sad and happy. It kind of felt like when you graduate elementary school, you are excited about the future but sad to leave a place and a time that you knew so well and were so comfortable with. The entire office was loving and excited - Maverick and I really appreciate it. So today, Maverick's WBC count was 1.4 which is low but still to be expected because of the high dose Cytoxan he got last week. The only other new and noteworthy thing medically was when Dr. Hazzah was checking Mavericks lymph nodes, she found a small bump about 2mm in size. She thought is was possibly another mast cell tumor and that the full body radiation will possibly/probably take care of it. This news was a little disappointing. Today in terms of treatment, Maverick got 10,000 mg of Elspar. This was his first time getting this enzyme.

1/17/09

So today we left for our big adventure to North Carolina. Before leaving we dropped Ruby off with Rachelle and her pack of dogs. Ruby was so excited to be with two labs and three golden retrievers and a bunch of other dogs. She was ready to love and play with all the dogs and Rachelle’s family. I am so glad we found Oso’s Canine Country Club. After we left Ruby, we finished packing for our big trip and cleaning up the house. Then we got on the road. Maverick seemed very excited. He hopped right up in the car and was ready to go. We drove to right outside Baltimore, Maryland. It is a little less than half way. Traveling in our Xterra is a lot easier than driving in the RV. We stopped twice on the way down for Maverick to go to the bathroom but other than that it was a smooth quick drive. We are at the hotel, La Quinta, a dog friendly chain. We plan on getting some rest (especially Maverick) and then going out to get dinner.

Today we started Maverick on his Neupogen injections he receives the injections twice a day. So far he has no reaction to getting the injections or from the Nuepogen. The common reaction from the Nupegeon is soreness. It supposedly feels like growing pains.

In the afternoon/evening I thought Maverick wasn’t feeling well. He seemed like he was uncomfortable or something. It turns out he was feeling fantastic and was ready to play. So first he played with an empty plastic soda bottle and then he played catch and chase with a racquetball. I am so glad he is feeling well.

1/18/09

Today we left Maryland and made it to Raleigh, North Carolina. It was an easy drive other than a little rain. Maverick was definitely done traveling by the time we got too the hotel. He was a little hesitant and whiny when we got back in the car to go to dinner and Walmart but I don’t blame him. I felt the same way.

He was also feeling pretty good this evening, we played a little ball and also did some training with him; sit, down, settle, paw, high five, etc.

The only other thing that happened was at the hotel our hotel room neighbors' little girl was scared by his big, loud, authoritative bark, so Maverick and Howie went over to say hello to her. The little girl loved him and said she was not afraid anymore. Maverick has this loving, gentle way about him especially around children.

1/19/09

Today was our first day this week with Dr. Suter.  It started off with us meeting with him and one of the bone marrow transplant technicians.  We got all the paperwork out of the way, discussed the timeline of the week and Maverick's recovery period, as well as all the risks and junctures still in front of us.  We learn that the GI toxicity from the radiation should not kick until 2-3 days after the full body irradiation and so during that time, he will be given whatever food he wants along with a course of ~6 effective GI medications to make every effort to counteract the diarrhea, vomitting, and other nasty side effects from the radiation.  In Dr. Suter's past 2 cases, vomitting has been minimal and the diarrhea had not been as bad as they thought it would be.  Also, we learn that unfortunately, we will not know if the grafting of the reinserted stem cells takes until about a week after the procedure meaning we will head home without Maverick without knowing this.  That is going to suck.

Dr. Suter drew blood and took a fresh bone marrow aspirate (both of which will have Flow Cytometry and PARR tests ran on them by tomorrow night) to see if the high dose Cytoxan and Elspar have helped to further reduce the low volume of abnormal cells in Maverick's marrow (if we could get a negative blood AND bone marrow PARR, that would be ideal).  A CBC was also run which showed that the Neupogen and further recovery from the Cytoxan raised his WBC from 1.7 to 8.8.  His bloodwork is fantastic for a normal, healthy dog now but his WBC is not yet where we want it for the leukapheresis process scheduled for Thursday (we want it >= 30.0).  It's only been 3 days since this count was 1.7 so he's on the right trajectory but to play it safe, Dr. Suter asked us to give Maverick a double dose of Neupogen tonight (300 mcg).  Tomorrow morning, we will do another CBC and then decide whether he should go back to 150 mcg doses or stay on 300 mcg doses between now and the stem cell harvesting.

We are also stopping all of Maverick's preventative antibiotics and lowers his Prednisone dose for the next 2 days to 10mg/day (1/3 of his current dose, as you can't just stop Prednisone immediately without some weening off).  This is to get everything non-essential out of his system in preparation for the procedure.  On Wednesday, he will be given the highest potentcy oral antibiotics 3x that day.  He will also be admitted to the hospital Wednesday late afternoon in preparation for his big days.

After Maverick's bone marrow aspirate, etc. were finished, Howie went to the isolation room with Dr. Suter to take a look at the setup to determine how he will mount and wire up the webcam which will be linked to this site so we and anyone else can watch Maverick as he recovers.

The day ended with some excitement because David Green, the Director of Communications for NCSU's VetMed school secured an interview for us with Julie Henry of NBC-17 WNCN, a local Raleigh television station (
www.wncn.com)!  The interview went very well and we learned that it will probably air Thursday night at 7 PM.  Julie will be back Thursday morning to interview Dr. Suter while Maverick is getting his leukapheresis.  David also informed us that we will be having a second interview with CBS WREL Wednesday at 4 PM!

One other piece of exciting news is that after returning to our hotel room, Howie received a phone call from the owner of another one of Maverick's littermates!  She and her husband agreed to have their dog tested tomorrow at their local vet so we have one other possible backup option if their dog, Dusty Silver is a match.  Howie will handle all the logistics for that tomorrow.

1/20/09

Today, Maverick went to see Dr. Suter at 8 AM.  He had a CBC done and the double dose of Neupogen had the hoped for effect - his WBC count shot up to 20.8 so we're getting close to the required 30.0 by Thursday morning.  Given this increase (from 8.8 -> 20.8 in one day), we go back to 150 mcg doses of Neupogen this morning, this evening, and tomorrow morning.  We will then do another CBC and see where we're at.

Maverick also had his second and final pre-transplant dose of Elspar (another 10,000 mg along with an injection of antihistamine).

We should have the results of the new blood and BM flows and PARRs tomorrow morning (our next meeting w/ Dr. Suter is tomorrow at 8 AM) - we are anxiously awaiting these because they are the next critical juncture of the week (only these results and the results of flowing the harvested stem cells remains as decision points before going ahead with the full body irradiation and BMT).  Tomorrow, I also plan to discuss with Dr. Suter any remaining diagnostic re-tests we might want to perform (full body X-rays, re-ultrasounding his splean where there was previously a small mass, etc.)

We learned today, from one of the hospital administrators, that we will unfortunately be unable to install a webcam to monitor Maverick as he recovers.  I understand the policies he cited related to privacy, but it is still disappointing.  He did say he will look into how this can be done going forward now that I've offered to install it for them.  The net of this is that there is almost 0 chance that this will happen for Maverick, but perhaps this can be done for future patients and their families.

A funny thing to mention is that Dr. Suter came up with two nicknames for Maverick that will probably be used while he's at their hospital - "Scarhead" and "Stubby Wagger" - Scarhead obviously from the scar on his head from where the first mast cell tumor was removed and Stubby Wagger is what Dr. Suter calls his Boxer at home!  We think these are great (and endearing).

After we returned to the hotel room after we stopped for lunch, we had a very lazy, restful day - all of us needed it, especially Maverick.  By dinner time, he was rearing to play with a ball so we did for a little while in our room.

A few more things to note today -

Dusty Silver (the other littermate of Maverick's that was found yesterday) went to the vet today in Illinois to get his blood drawn and the samples are on their way directly to Dr. Wagner so he can run the genetic matching tests on the 3 potential donors as a backup to the autologous transplant we're doing this week.  We are very grateful to Dusty's owners for being so quick to help us and Maverick out!

We got a few responses to an e-mail I sent last night informing the team participating in Maverick's care (people from Broad River Animal Hospital, Veterinary Oncology & Hematology, Dr. Suter, Bellingham Veterinary, Dr. Bergman, Dr. Wagner, and everyone else) telling us how Maverick is in their thoughts and that everyone is pulling for him - these e-mails were very warm and fantastic!

Tomorrow is another big interview day for Maverick - CBS WREL will be meeting us at the VetMed school at 4 PM.  More to come on this tomorrow.

1/21/09

Today was a big day for Maverick and happily, we was feeling wonderful for it!  His blood flow cytometry and PARR results came back and they were excellent!  A negative PARR with a 2% population of CD34+ cells tells us that almost certainly those are stem cells and not cancerous cells (1-5% is a normal CD34+ cell population for a dog on Neupogen)!  The bone marrow PARR unfortunately still came back positive meaning that not all cancerous cells in his bone marrow have been obliterated, but this was an expected outcome.  The stem cell harvesting tomorrow is a go and therefore, Maverick will be admitted to the VetMed hospital tonight so he can be prepped for a central catheder insertion and leukapheresis beginning at 7:30 AM.  Leukapheresis should begin around 10 AM and should last for approximately 5 hours to ensure they collect enough volume for reinsertion after full body irradiation.  The only last hurdle is to perform a flow cytometry on the harvested cells to ensure that there are no or practically no cancerous cells in the harvest.  If that goes well (and we expect it will based on all the test results we have had up until now), then the full bone marrow transplant procedure scheduled for Friday will proceed.  Also, today's CBC results show Maverick's WBC has further gone up to 25.  This is close enough for stem cell harvesting, but we still ideally want >= 30 so Maverick is going to get 300mcg of Neupogen this afternoon, again this evening, and a final time tomorrow morning (so 7 doses in a day and a half to not risk us not meeting this bar).

We want to thank the entire staff at the NCSU VetMed teaching hospital.  Everyone has been so wonderful, caring, and loving.  We know that Maverick is in excellent hands and he does too - he loves everyone there and gets so excited as we drive up!

We had an interview w/ Ken Smith of WRAL5 today at 5:15 (instead of the originally scheduled 4 PM due to a necessary delay so their cameraman could attend) which went extremely well and which will air tomorrow morning between 5 and 7 AM on their morning show.  Both WRAL and WNCN will be back tomorrow to interview Dr. Suter and film a portion of Maverick's leukapheresis.  Also, during the time window during which media are invited to witness the procedure, David Hunt of NCSU's media department will come by (we had a 15 minute telephone interview with him today - he is working on a story for NCSU's website), as will a freelance writer.

We discussed further pre-transplant diagnostic tests (redoing a splean ultrasound, etc.) w/ Dr. Suter and we decided to not do this until after Maverick's recovery from the transplant since the full body irradiation should destroy all remaining cancer cells.

Maverick had his last dose of 10mg Prednisone this morning and was started on an intensive regimen of oral antibiotics (1 as a potent broad spectrum antibiotic to prevent infection and clean out his system of any remaining bad bacteria and 2 to clear his GI system of bad bacteria in preparation for the transplant - Neomycin Sulfate 6mg/kg 3X per day, Polymyxin B 25,000 units/kg per day split into 3 doses, and Baytril 10mg/kg 1X daily).  He will remain on this course until at least discharge after recovery from the transplant.  Post transplant, Maverick will also be on a whole slate of other drugs (I will update the website with details of this soon).

We set up a Donations page on this website to solicit donations to help advance NCSU's Bone Marrow Transplant Program as well as to help finance canine cancer treatments for those who cannot afford them.  We will be meeting with an NCSU administrator tomorrow who we can work with on this part of what we want to do.

1/22/09

Today was a huge day in terms of Maverick's Bone Marrow Procedure. Today was Harvest Day. Dr. Suter and his team used the leukepheresis machine to harvest Maverick's stem cells. They also put in a jugular cathedar which will remain throughout his entire bone marrow transpant procedure as well as two cathedars on his back legs. One of these cathedars will also remain.

We got to see Maverick for a few minutes during the procedure. He looked like he was doing great. Maverick was only lightly sedated so when he heard Howie's voice, he lifted his head and tried to see him. We stepped out of the room at that point. After the procedure was finished, we spent some time with Maverick taking him out to use the bathroom, loving him, and feeding him.

Halfway through the procedure as well as at the end of the procedure blood was drawn to run a flow cytometry. The results were a little stange. Although there was an ~3% population of desired CD34+ stem cells, there was also a 6% population of unknown small size CD34+ cells. Though this baffled the doctors (they have never seen a population like this before), they cells do not appear to be cancerous. We decided through discussion with Dr. Suter to continue to go ahead with the total body irradiation and transplantation.

We also had camera crews from 3 local TV stations film the procedure - NBC17, CBS5, and ABC11. The stories played in the evening and CBS5 reran a portion of the story on 1/23 in the morning. We also were intererviewed by a freelance science writer and David Hunt from the NCSU News Department. This story is really getting out there in the public eye. It is taking on a life of its own and people are sending well wishes and blogging about Maverick's case - it is amazing.

We also decided to do an ultrasound, bone marrow cytology and PARR to make sure we killed all cancer from the radiation after the stem cell engraftment takes and the radiation therapy has had a chance to kill all the cancer cell it will (it takes ~5 days for them to die after radiation is given).

Additionally, we spoke with the people in charge of the Veterinary School's foundation, whom we will work with to solicit donations to help advance Dr. Suter's Canine Bone Marrow Transplant Program and also to help finance treatment for those who cannot afford it.

1/23/09

Today is Howie’s 30th Birthday and Maverick's Transplant Day. We went to the hospital to see Maverick at 6:30 AM prior to his full body irradiation. This is the last time we are able to see Maverick until the procedure and recovery are over in about two weeks. Not seeing him is the hardest part for me. He began IV antibiotics this morning and we saw that after removing one of the catheders in his legs becase it was not flushing properly, he was swollen - this is not a big deal though and should clear up in a few days (they heat packed it a couple of times already). He also took out the other leg catheder - I guess we shouldn’t have taught him how to take off his own leg bandages! They irradiated his whole body for 2 ½ hours, then took a 3 hour break, and then irradiated his body again for another 2 ½ hours (for a total dose of 10 Gy, the highest possible dose that he can tolerate without it being fatal). Maverick vomitted after his first round of radiation, which is an expected thing given the amount he was exposed to. Fortunately, he only did that once. They do 2 rounds with a break between and give each 5 Gy dose as slowly as possible to kill as many splitting cancer cells as possible (instead of just blasting him once which would only kill cells splitting at that moment).  After the irradiation was complete, they put back in his healthy harvested stem cells. Then Maverick went into an isolation room and we have to wait and see if the stem cells graft. Maverick was feeling good again once in the isolation room and he should be eating and behaving normally for the next couple of days, until the GI side effects of such high dose radiation treatment begin to manifest (he has already and will continue to be given the strongest GI side effect reducing drugs available).  Those should last for approximately 1 week, while simultaneously, the engraftment process should take.  At that point, he should be feeling great again but he must still be kept in isolation with as low a level of activity as possible as his platelet count will still be low for approximately 1 additional week.  Once all his blood counts are back to normal for 3 straight days, he can be discharged.  The moment we are allowed to see Maverick again, we will be back at NCSU but until then we will go home.

We know Maverick is in the best of hands and we will be receiving daily updates on his progress from Dr. Suter.  We will also be receiving some photos along the way during his recovery.  The nursing staff is excellent and we are extremely comfortable with the care Maverick will receive while at NCSU.

As we wrapped up the day, we spoke to Dr. Suter about what is necessary to help advance his program and take it to the next level.  Although his program is already at the forefront of clinical canine oncology, there are 2 primary things that would make it world class - one is the ability to purge harvested stem cells in cases where cancer remains in the harvest and the second is the ability to cryofreeze harvested cells.  I will put more detail about this as part of the goals on our
Donations page shortly.

1/24/09

Today we left for home. Since Maverick must be in semi isolation for the next two weeks or so, there is no longer anything we can do for him but pray and wait. Leaving was so hard. I cried on and off most of the day.

Dr. Suter e-mailed us with an update. Maverick is doing well, he is eating like a champ, his blood work is getting back to normal after the Neupogen, and his is bored. Dr. Suter spent some time with Maverick singing and rough housing (two of Mavericks favorite activities). I know Maverick is in great hands. The only thing to really report is that Maverick keeps trying to chew on his IV lines. But the veterinary team seems to be taking care of that, with the help of a ridiculous e-collar. So far he has not been sick at all
(we excpect any day now to have vomiting and diarrhea). He is currently on a maintenance dose of fluids (70 mls/hr), but that will be increased as his diarrhea kicks in.

1/25/09

According to Dr. Suter’s report, Maverick is still feeling great. Eating, sleeping, peeing just like normal. He tried to pull out his jugular cathedar but luckily he was caught in the act before he really hurt himself. He has also been chewing through his IV lines. Maverick is a very determined boy just like his father. The hospital staff is working on different configurations with the e-collar and bandages to combat this.

The funniest thing to me is he has convinced the hospital staff to feed him only canned food. Not only is he smart for convincing them that he will only eat canned food, but also very spoiled.

Maverick started another broad spectrum IV antibiotic today Unasyn at 22mg/kg IV three times daily and Flagyl. Dr. Suter also increased his Ondansetron and started Metoclopramide - two GI medications.

Maverick is extremely bored and antsy, this is especially hard because he is feeling well.

We returned home in the evening, picked up Ruby from where she was being boarded and finally went home. It has been a long, tiring trip but it was very hard to be home because Maverick was not there. Sleeping was not the same without him. I got up to check on him but he wasn’t there. It is really sad.

1/26/09

Unfortunately, Maverick has been showing signs of GI side effects. He stopped eating and has begun vomiting. Although we are aware that these are normal side effects, it is difficult to hear he is sick and even more difficult to not be with him when he is sick. His fluids have been increased to help with keeping him hydrated and luckily these symptoms should only last until the end of the week.

The only other stuff going on is the website has been crazy - tons of people reading everything, sending notes filled with love and support. We are so grateful.

Dave Hunt also finished his article for the NCSU website and staff bulletin. I think it is really well done. It has been linked to on our Media Coverage page.

Some good news late received later in the day was that Maverick responded extremely well to increased doses of GI medications given in response to him showing initial radiation side effects.  He ate a little (some low fat liver treats and a handful of Z/D) and stopped vomitting.

He was still messing with his IV lines (chewing through them 4 times today) and his jugular catheder.

1/27/09

Dr. Suter had to go in at 2 AM this morning to resew Maverick's jugular catheder after he managed to rip some of the stitches out and scare the entire staff.  After this, they again tried to resnug his e-collar.

He's eating enthusiastically today again though (Z/D) which is great and his feces are only slightly soft.  He's urinating normally.  His Neutophil count is starting to tank, which is expected (down to 200 from 2,800 yesterday) with his other cell counts still looking OK (some are low, but nothing in the danger zone yet).

Tomorrow, his Neutophil count should be down to 0 and I would expect other cell counts to be extremely low as well (again, expected side effects of the radiation until his reintroducted stem cells begin to engraft and produce new bone marrow function).

The best news of all is that the PARR results came back for the leukophoresis blood sample (the batch of harvested stem cells) - COMPLETELY NEGATIVE!!!!  This means that as far as the most precise, molecular level test can tell, the reintroduced stem cells were CANCER FREE!!!  If the radiation got rid of all remaining cancer cells in Maverick's body (we will test this in a week or so with another round of bone marrow and blood flow and PARR tests), then there is a good chance the procedure was a total success!  We remain cautiously optimistic, but this is excellent news.

1/28/09

We are told by both Dr. Suter and one of the nurses that Maverick is feeling great today. Dr. Suter has a new nickname for Maverick, "Mr. Tough Gut." This is because Maverick should be a little sicker than he is. He is eating and pooping like normal. His Netrophil count was down to 22 today. Tomorrow it should hit zero and once that happens he will be feeling lousy. Then we must wait for his Neutophils to rebound which should take a couple of days. The staff had to start giving Maverick Benadryl to keep him a little calmer. It sounds like he is full of energy and wanting to play. Unfortunately, he can’t play right now.

Also one of Maverick's nurses sent us some pictures of him which are now linked to from the Photos page. I am just glad to see him. It was nice of her to send the pictures.

1/29/09

Just as expected, Maverick feels really lousy today. He is not eating and vomited just once this morning. He is also running a fever (102.6, which is 2 degrees higher than his normal body temperature). His Neutophil count dropped down to 1. We were told this would happen and he would feel like this but a part of me hoped he would never feel sick and that somehow he would be the exception to the rule. Hopefully he will not be feeling bad for very long.

We must pray that his transplant kicks in as expected and that his Neutophils begin to rebound tomorrow or on Saturday.  Once past that hurdle, the next big one is for Maverick's platelet count to rebound after it should hit its low on Sunday (which makes any injury very dangerous since platelets are responsible for clotting).  If all goes well, his platelets should be back to a safe level by the middle to end of next week and at that point, he can be tested to see if the transplant was a complete success or not.  And then, we would also get to go pick him up and finally take Maverick home!

That is all the news for now. I am just missing him terribly and wanting to be with him and taking care of him or at least loving on him.

1/30/09

Maverick is feeling much better today. His temperature has dropped and he is eating and using the bathroom normally. It is such a relief that he is feeling better. It is so hard worrying about him and being unable to do anything or even see him. We also got word that his Neutrophil count is up to 3 from 1 and if this is accurate, which they will check again later in the day, then Maverick’s procedure was a success. This might be the best news I have ever heard. Maverick has just been so amazing throughout this process, he is so tough no matter what the leukemia, chemo, steroids, radiation, and bone marrow transplant threw at him. As I have been saying for a long time, even before the cancer, Maverick is an exceptional dog.

So we received another update from Dr. Suter. Maverick is still doing well and his neutrophile count is still 2. It seems as if he is on the road to recovery. Let’s hope the road is smooth and quick. Dr. Suter cut his fluids in half today and plans on cutting them in half again tomorrow.

1/31/09

Today was a really bad day. It started off with Maverick having a nose bleed (at 3 am) which was not really clotting. The nose bleed and lack of clotting are due to his low platelet count. Later on in the morning, the nose bleed increased and raised concern for the treatment staff. His CBC was especially worrisome - RBC count of 15 and platelets at 3 k/ul . His neutrophil count has not gone up yet, in fact it was at 0 today, the lowest so far. Typically, the neutrophils will begin increasing before the platelets disappear, but that's not the case with him. Because of the concern about Maverick's CBC, Dr. Suter decided that a whole blood transfusion is our best bet at this point. This was admittedly very upsetting and scary to both Howie and myself. Also I feel I must say that Dr. Suter did talk to us before the BMT that this was a possibility. So Maverick received blood from a donor dog named Cierra. We are so thankful to Cierra and her family. Maverick received 450mls of blood. On a side note, I would love to get involved in a blood donor program with our other dog Ruby in our area. It is such a wonderful program. Maverick also received a dose of neupogen and will receive another dose in the evening to jump start his engraftment.

Other than all this, Maverick seems to be feeling fine. He is eating quite a bit, drinking, and using the bathroom regularly. Dr. Suter decided to decrease his fluids today.

2/1/09

Thank God. Today was a much better day. Maverick appears to be feeling really good. Eating, drinking and using the bathroom normally. His nose stopped bleeding, which means the blood transfusion helped. Dr. Suter stopped all of Maverick's IV fluids today and took off the annoying e-collar. He also started him on some new GI meds (Pepcid and Prilosec) in case he is having a small amount of GI blood loss that could be contributing to his anemia. The CBC results are fantastic today. The WBC are 110/uL (were 20 yesterday). The Neutrophils are 59/uL (were 0 yesterday). The Platelets are 23k/uL (were 3 yesterday). The Hct are 20% (was 15 yesterday and 16 1 hr post-transfusion). The numbers are great and it is unlikely that all of the good is from the transfusion yesterday. Dr. Suter said that as long as the numbers are up more tomorrow, then the BMT procedure was a success. Dr. Suter also decided to give him two more doses of neupogen, just because we want to be on the safe side and we are all very impatient.

2/2/09

So all is mostly good. Neutrophils today are 248!!!! Maverick is definitely engrafting. In Dr. Suters experience, these counts tend to double every day from here. At this rate, Maverick should be leaving isolation by Thursday (which I know he will love, being around more people and seeing more animals). His platelets are unfortunately back down to 2, which Dr. Suter says is not much of a surprise since platelet rebound tends to lag 2-3 days behind Neutrophil rebound. Maverick's nose is just oozing a little bit of blood. Dr. Suter has decided to give Maverick an infusion of fresh frozen platelets (500 mLs). Maverick was also exhibiting bruising under the skin called ecchymosis. Later on in the day, after the platlete transfusion, Dr. Suter noticed more bruising and decided that Maverick needed another whole blood transfusion (1 unit), this time from a wonderful dog named Riley. This was and is very worrisome to Howie and myself. His Hct is 22 today. Despite all of the transfusions and worry, Maverick has been feeling great today and was howling along with Dr. Suter again!  Now we will start making plans to go get Maverick. It seems overwhelmingly suprising how well he has done overall with all of this. He has been missed terribly but of course all of this was worth it. I just can’t wait to kiss him all over, lay in bed with him, cook for him. I can bet he feels the same way too.

2/3/09

Today Maverick is reportedly doing well. He is eating and looking well. There are no new bruises so let's hope the bruising is behind us, as well as the blood transfusions. Maverick's CBC is really great today. Neutrophils are 654 (up from around 248 yesterday). Hcts are up to 31 (up from 22 yesterday). Platelets are 21k (up from near 0 yesterday). The Hcts and platelets are up due to last night's transfusion, but tomorrow's CBC will hopefully show that his Hcts continue to rise along with his Neurophils (to above 1,000/uL which would mean he can be taken out of isolation), but also that his platelets have begun to rebound.  This whole BMT has been such a emotional roller coaster, filled with such highs and lows for us. It is especially hard not being with him and only getting news via e-mail. It is very difficult to get bad news through this medium.

2/4/09

The WBC count is 1020, Neutophils are 928, Hct is 29.2, and platlets are 2. Maverick's platelets were non-existent (listed as 0.5 which is essentially 0) before his transfusion on Monday, so this is either residual from that or they are starting to rebound. Maverick was well enough to be moved out of isolation and into the general hospital population! I am sure he is loving the freedom, seeing all the people, and seeing other animals. Maverick was also well enough to go outside. For the first time in two weeks, Maverick used the bathroom outside, felt the wind under his ears, and smelled the fresh air. This has to be amazing to him.

Maverick is only on one IV medication, Unasyn. All the rest of his medications are now oral. This means they will be ready to remove his jugular cathether soon, probably tomorrow.

In terms of Maverick’s after care, he will only need a CBC twice a week and no medications as of this point. That sounds so exciting.

2/5/09

The CBC today showed - WBC 1300/ul, Neutrophils 1195/ul, Hct 29, and Platletes 2 L. Maverick looks great according to Dr. Suter. His jugular cathedar was pulled today and Maverick is now off all medications except for some oral Baytril. His nose is no longer bleeding or oozing and there are no new bruises. In the evening, they rechecked his platelet count and it was up to 4. Finally, it seems like the platletes are responding.

On 2/7, we learned that Dr. Suter performed a flow cytometry on Maverick's blood today and it showed a population of those same small sized CD34+ cells as his harvested batch did (which they still don't know what they are or what this means, but don't believe they are cancerous).

2/6/09

This morning's CBC showed that Maverick's platelet count remained at 4 which probably means that they will not be going down again.  Also, the indicator on the CBC representing how many new platelets are being formed by his marrow is very high meaning that we have great news - that a huge amount of new platelets are being created and the rebound should continue as expected and hoped.

We dropped Ruby off as Oso's again and began the drive to NC.  We stopped in Alexandria, VA for the night and will give Dr. Suter a call when we arrive in Raleigh tomorrow.

2/7/09

We arrived in NC mid-afternoon and Dr. Suter met us at the VedMed school - we saw Maverick for the first time in 15 days and he looked amazing!! He was so excited to see us but it was obvious that he was not completely himself - he was tired and limping a little.  He has been through so much and he needs time to fully recover.  But we took him for a little walk and gave him lots of love for about an hour before he went back in to rest.  His platelet count this morning was up to 17k/uL (from 4 the day before)!!  So the final hurdle of platelet rebounding is behind us.  Now he needs to get above 25k/uL so it is safe for him to leave the hospital (with >= 50k/uL being ideal).

We plan to meet Dr. Suter and Maverick at the hospital tomorrow morning at 9AM for his CBC blood draw.  After that, we will get to take Maverick home Monday!!  This is the perfect birthday gift for Marna, as her birthday is tomorrow (Sunday).  We last saw Maverick on Howie's birthday and get to see him as healthy as can be on Marna's!!  Monday morning, there will also be news crews on hand to document this momentous occassion - the first successful BMT performed on a dog with acute leukemia!

Another flow cytometry performed today on Maverick's blood showed that the unknown, strange population of small CD34+ cells has evaporated and his blood (from the results of both post-transplant flow cytometrys) appears to be cancer free!!  This is a great first step in seeing signs of the procedure's success.

Unfortunately, we will not know if this procedure has cured Maverick until later in the week.  First thing Monday morning, an abdominal ultrasound will be performed to see if the lump in his splean has been obliterated and a bone marrow aspirate will be performed to run a flow and PARR on - if those come back negative, then he will be considered cured.  If not, then we will have to cross that bridge when we come to it with what it means for the future and his continued treatment.  Hopefully, this will not be what happens.

We grabbed a hotel room for the next two nights and will update the site again when we know more and when the next batch of media coverage occurs.

2/8/09

We spent a good hour with Maverick this morning!  We played ball and he got to run around for the first time since before the transplant.  His CBC looked great - Neutrophils up to 1600, Hct > 30, and Platelets at 27k/uL!  He is definitely ready to go home tomorrow!!

Maverick was pointing, following commands, and having a wonderful time in the 70 degree weather!  He loved being with us and loves playing with Dr. Suter also!

This is turning out to be the best birthday ever for Marna!  We are going to go to the circus this afternoon to celebrate and then see Maverick again this evening before taking Dr. Suter and his wife, the other Dr. Suter to dinner to thank them for the excellent work and care Maverick got.

Tomorrow morning, all of Maverick's last post-transplant tests should be done by 11 AM and we are still waiting to hear what the media schedule will be.

2/9/09

Maverick is coming home today! Hooray! When I woke up this morning, I was instantly aware what a huge day today was. Prior to our arrival at the Veterinary Hospital, Maverick had his post BMT tests done. He had a bone marrow aspirate and an abdominal ultrasound. The ultrasound of his spleen showed no signs of the lump that existed from the original ultrasound back in November. However, the ultrasound found a possible condition in his gall bladder. His gall bladder is filled with sludge, a sign that he may develop a condition called a biliary mucocoele (which is a non-neoplastic lesion - the result of gall bladder sludge that can end up developing into a solid mass). We will keep on an eye on his gall bladder through monthly ultrasounds. If it gets worse, there is medication or surgery to take care of it. In terms of the bone marrow aspirate, we do not have PARR results yet. They should be in Wednesday evening. A pathologist looked at the bone marrow (as did Dr. Suter) and did not see any cancer. So at this point in time, Maverick is considered to be clinically cancer free. The BMT was a success! And all of the time and worry were totally worth it.

We also had Julie Henry from NBC-17 and a cameraman from WRAL-5 come and film Maverick’s deperature. Both stories aired that evening and are linked to from our
Media Coverage page.

We said our goodbyes and thank you’s to Dr. Suter and began our trip home. Maverick was glad to be with us and glad to be in the car returning home. He unfortunately banged his back left leg getting into the car and has a giant swollen, pink welt. The injury looks especially severe because of his low platelet count. We iced his leg and are now lifting him in and out of the car. We drove about 5 hours and stopped at a La Quinta (a dog friendly chain) in Waldorf, Maryland. He didn't eat his full dinner this evening. On a side note, La Quintas are pretty disgusting. I do not suggest them, and I will begin looking for a new dog friendly chain.

2/10/09

We drove the rest of the way home today. We were all very glad to get home especially Maverick. Upon returning home we began to notice Maverick seemed to not be feeling well. He was drinking a ton of water and peeing a ton, he was in pain from the bruise on his leg, he had an elevated temperature, he was just generally not feeling well. After consulting with Dr. Suter, we decided to be on the safe side and take him to the Emergency Vet in Norwalk. We saw Dr. Ross who was quite good. She took a CBC, a SuperChem, a urinalysis, and generaly checked him out. All the tests looked normal except the urinalysis which we are still waiting on the results from, and the Superchem showed elevated liver values (the same as he had the day before when he was still at the vet hospital - Dr. Suter attributed these and other abnormalities to Maverick just having been through a lot and needing time to normalize - we will monitor everything and take appropriate action if and when necessary).

Maverick spent the entire night once we got home going to the bathroom. He had me up once an hour every hour to take him out to the bathroom. He also spent much of the night wandering around the house trying to find a comfortable spot to rest.

2/11/09

In the morning, Maverick was still feeling not right. He had a slightly higher elevated fever, he vomited twice, he was shivering, and had soft stool. We called Dr. Suter again. He suggested just letting Maverick rest and waiting to see what the urinalysis said. So that is what we are doing as of this point. Maverick is asleep in a little ball under my right arm as I write this entry. I will touch base with the oncology team in Norwalk, the vets over at Broadriver and Dr. Ross at the emergency place today. Other than that, I will let Maverick rest and catch up on website stuff and e-mails. Hopefully he will just begin feeling better after a couple of hours rest.

Later on in the afternoon, Maverick had some diarrhea which is not normal for him. I called our oncologist, Dr. Hazzah. She felt like given the general way Maverick has been feeling and the diarrhea that he should start taking some Metronidazole. He began taking 250 mg twice daily for a minimum of three days.

2/12/09

Maverick woke up feeling a bit better. He only went out two times during the night. The biggest thing to me at this point is his tail is up again. He is still exhausted which makes sense given all he has been through, so he will continue to rest all day to day.

The extraordinarily exciting news for today is that the results are in for the post-transplant bone marrow and blood PARR and Flow Cytometrys and Maverick is cancer free!! They are a little concerned about some bands they saw in his BM PARR and will run some further tests with the results to come in next Wednesday. But as of this moment in time, the bone marrow transplant was a complete success. And I am over the moon thrilled about it.

2/13/09-2/20/09

So over the past week, Maverick has begun to show signs of feeling better. He has had no vomiting or diarrhea for several days. He no longer has an elevated temperature. He only has one new bruise on the inside of his back right leg. He is still lethargic, he rests or sleeps nearly the entire day. He is still peeing and drinking a lot, but I feel like even these symptoms have improved over the past week. But his personality is coming back. His tail is back up and wagging. He is back to guarding the house, barking when he hears something. He kisses again. He meets you at the door when you come home. It is pure joy to have him home. He is so loving and affectionate, I do not know how I survived all those days without him.

On Tuesday, we went to see Dr. Hazzah for a check up. This was the first time she had seen Maverick since he returned home from NCSU. Overall, she thought he was looking great. He definitely is skinny now. Since Thanksgiving when we first began chemotherapy, Maverick has lost 11 lbs. It really shows, you can see every bone on him now. I am slowly working on getting his weight back up. He is eating several home cooked meals a day consisting of some variation of chicken, eggs, sweet potatoes, rice, and kibble. He is a happy boy and his sister is also receiving tastes of all this. The only thing to really note from this visit is Dr. Hazzah was able to feel his lymph nodes in the throat. This raised some concern. We may aspirate them next week, when he is feeling better. We ran a CBC, super chem panel, and had a pathologist review the blood slides.

On Wednesday, we received the results of all of the tests. The test showed his platelets are not as of yet bouncing back further. His platelet count was 16 and the normal range is 170-400. Of course it takes several weeks maybe even a few months for the platelets to normalize. Dr. Suter says this is the last thing to come back up after the transplant. His WBC were 4.3. His RBC 4.25. All of which is good. The only other concern we have from the test results is that his liver enzymes are still elevated, they are actually a little higher than last week. All of Maverick’s medical team talked about the results and came to the conclusion that we should have a bile acid test done. The Bile Acid Test is one that measures how the liver functions and performs. The dog is fasted, blood is drawn, the dog is fed a fatty meal and the blood is drawn again 2 hours later. The blood tests measure pre- and post- meal levels of bile acids, the acids stored by the gall bladder and secreted by the liver. He is scheduled to go in Friday morning (2/20). Hopefully after the test is perfomed, we will have a better idea what is going on with his liver. Dr. Post also wanted Maverick to start a course of Zeniquin and Probiotics (one of Dr. Suter's ideas).

In the late evening, we received an e-mail from Cathy von Haartman. Her dog, Bailey, received a transplant from Dr. Sullivan several months ago. She has a fantastic website, that is a great resource. The website is www.savebailey.com.

On Thursday, I spoke with Dr. Hazzah. After thinking about Maverick's case and talking to Dr. Suter, they decided to switch Maverick from Zeniquin to Clavamax because he has been on Zeniquin for several months now. She also spoke to Dr. Suter about putting Maverick on a antioxidant called Alpha Lipoic Acid which should help with his liver.  It is a strong antioxidant and is known as a 'liver protectant.'

On Friday, Maverick had his bile acid test performed by Dr. Frazier at Broad River Animal Hospital.  We should have the results within a couple of days and we will then be able to decide on a course of action (everything from doing nothing more than keeping him on Alpha Lipoic Acid and antibiotics for the next couple of weeks to performing an abdominal ultrasound and adding more aggressive liver protectant drugs).  During this visit, Dr. Frazier confirmed what Howie thought the day before - that Maverick's lymph nodes were no longer enlarged.  This could have happened for a variety of reasons, including the couple of days' worth of Zeniquin he was on at this point and we will of course, continue to monitor them.  We started the Lipoic Acid today - Maverick received 300 mg twice a day with his breakfast and dinner.

At this point, Maverick still seems to be getting better a little bit each day, which is great!

That is all for now - thank you for checking in! Please continue to check back, however I am planning to start updating weekly rather than daily from now on.

2/21/09

So, we received the test from Maverick's Bile Acid Test.  The tests came back mild to moderately abnormal.  That means his liver is not processing food normally.  The next step in determining what exactly is going on with his liver is to get a abdominal ultrasound.  He is scheduled for his ultrasound this Tuesday at 11, right after his weekly oncology check up with Dr. Hazzah.  It is important to note, that his liver issue may all be from his full body radiation.  This issue may just work itself out.  Let's hope.

2/22/09

Just a quite day at home.  The dogs are resting on the bed nearly the entire day.  Maverick is still extremely tired, but he has been through so much.  Overall he feels much better.

2/23/09

Maverick spent the whole afternoon laying on the kitchen floor, basking in the sun.  I am anxiously awaiting Mavericks oncology appointment tomorrow.  I know he is feeling better but am curious what the tests show.

2/24/09

Maverick and I just got back from his weekly check up with Dr. Hazzah.  His check up went well overall.  He is really looking much better.  Maverick had his abdominal ultrasound done.  Luckily, his liver and everything else looks good.  His gall bladder looks the same as it did when the ultrasound was performed at NCSU.  This is all a huge relief.  Maverick's lymphnodes were still enlarged.  Although they were smaller then last week and a little bit softer.  Dr. Hazzah aspirated the lymphnodes to see what is going on inside of them.  Maverick platelets are still incredibly low, so when the lymohnodes were aspirated he began to bleed.  His body was not clotting very well.  The staff at the oncology center iced the area and put pressure on it.  The area stopped bleeding within a short while.  The area where the aspirate was done swelled up to about the size of a baseball.  I will have to keep an eye on it.  We will continue to be very careful.  Maverick will stay on Clavamox 375 mg twice daily for at least another week, 300 mg twice daily of Alpha Lipoic Acid, and Acidophilous.

We should hopefully have results of the CBC, Superchem, and lymphnode aspirate tomorrow.  I will let you know, when I know.

2/25/09

The results are in.  Maverick's Superchem shows that his liver enzymes are fixing themselves.  They are almost in the normal range.  Hooray!!!  His WBC is 3.2, a little low.  The RBC is 4.24 also a little low.  His platelets are down to 13 this week from 16.   However according to the doctors a count of 13 is not really any different from a count of 16 because there are so few platelets to count.  Overall this is very good news today.

Mavericks enormous swollen and bruised neck hematoma is improving.  The swelling has definately gone down and the bruising is worse, which means it is healing.  Also Maverick is not as uncomfortable as he was.

Tomorrow we should have the results of the lymphnode cytology and the pathologist report.  I will keep my fingers crossed.

2/26/09

The cytology came back normal.  There is no disease in his lymphnodes.  That is a huge relief.  The pathologist confirmed that his actual platelet count is around 13 and that she saw a good number of small (or baby) platelets.  This is great, it means he is producing platelets.  Now we just have to get his platelet number up into the normal range.  Even if we could make it to 25 he would be in a safer range.  With platelets this low Maverick bleeds and bruises very easily as we saw from his lymphnode aspirate on Tuesday. 

Mavericks hematoma is now all covered in bruises and is no longer swollen.

2/27/09

Dr. Suter and Dr. Hazzah discussed the results of Maverick's CBC and Superchem.  Overall, they were quite pleased just like us, however Mavericks platelet count is a concern.  According to Dr. Suter his platelets should be much higher by now.  They think that Maverick has possibly developed ITP or Idiopathic Thrombocytopenic Purpura.  ITP is the condition of having a low platelet count for a unknown reason.  Most cases of ITP are caused by andtibodies against platelets.  In ITP, antibodies coat the surface of the platelets, destroying them and causing their level to drop.  My understanding of all of that is that Maverick's immune system is fighting and killing his baby platelets.  Luckily, prednisone is proven to be an effective drug in helping this.  A drug we know very well from our days of chemotherapy.  Maverick began taking 40 mg per day of prednisone and 10 mg of pepcid.  According to the doctors and the research if Maverick does have ITP by his next CBC his platelets should be going back up.

Maverick is feeling well.  His appetite has been a little off, not eating a full meal when offered but that is all.

3/1/09

Today was Grandma Anna's birthday and we went to go see her for several hours (about 4) without the dogs.  We have been pretty much with the dogs, especially Maverick, almost constantly.  When we returned home Maverick had peed all over the third floor of the house.  It looked like he leaked or dribbled in some areas and in others just completely peed.  It was such a mess.  But more than the mess I was worried about him, Maverick has never used the bathroom in the house since he was a puppy.  He must have been so uncomfortable.  I felt so bad for him.  The prednisone I believe is responsible for this.  I also made the mistake of leaving a bowl of water out for him, in the past he would never drink while we were out, but this time he did.  Poor Maverick.  He also has been getting up several times a night to use the bathroom, the average is 5 lately.  I hope that once he gets used to the prednisone his bathroom needs will be less urgent and often.  I also hope in a few weeks that his platelet count comes up and he can be taken off of the prednisone.

3/2/09

The big snow storm hit today.  Generally Maverick, Ruby and I absolutely love the snow.  But this time Maverick seems completely uninterested in it.  He has been going out to use the bathroom and then coming right inside.  He seems to only be interested in eating, sleeping, and drinking.  It makes me sad.  I really miss the old Maverick.  I am so thankful for having him home and having him healthy.  But I look forward to the old Maverick coming back.

3/3/09

Today, was Maverick weekly check up at the VHOC.  Dr. Hazzah said he looks great.  His weight was down a few ounces but no big deal.  She checked all of his lymphnodes, all were good.   Thank goodness.  We sent our Mavericks CBC and Superchem to North Carolina State.  Hopefully the results will be in tomorrow.


3/4/09

Results are not in today like I had hoped.  So we must wait one more day.  I don't mind waiting another day for good news.

Maverick is still resting quite a bit.  His appetite is a little on the low side but I am trying to keep eating with yummy treats like cheese and turkey.  So far that is working pretty well.  Maverick is still peeing and drinking like crazy because of the prednisone.

3/7/09

I haven't written in a couple days, because there was no news to share.  On Friday we found out there was a problem with the blood sample and the lab was unable to run the CBC.  So, Friday afternoon Maverick and I were back at the vet having a second sample drawn.  We should have results Monday.  Dr. Brodsky, one of the doctors at the VHOC, ran an in house CBC which I have been told is not very accurate.  According to that CBC Mavericks platelet count is 8.  Hopefully the lab CBC reports a much higher number.  I will let you know.

The exciting news is that Maverick now has his own facebook page.  Howies set that up this morning.  Technology is amazing.  So go take a look and become a fan.

3/9/09

The results are in Mavericks CBC looks good, other than his platelets.  Platlets are now 12 down from 13 last week.  That is no big deal in terms of the drop.  We will stay on the prednisone in case it is ITP and hope to see a big change next week. We will go in next Monday the 16th.  It is very hard getting this type of news every week.  But I know Maverick will be back to normal soon.  It is just taking him a little longer than expected.

Other than his platlets Maverick is doing great.  He went to the park on Saturday for about 20 minutes and ran around.   He had a blast.  On Sunday he played ball in the house with his sister.  His apetite has been good, he is slightly less lethargic.  He is even going out to use the bathroom less at night, just three or four times.

We got news today that Cody is going home tomorrow from NCSU.  Hooray Cody!!! We also heard that Molly's is doing well and is leaving isolation tomorrow.  On top of all that Punky is arriving from LA to NCSU to begin the bone marrow transplant procedure.  Dr. Suter is one busy, busy man.

3/17/09

Sorry I have not written in awhile, I just kept putting it off.  There was nothing to report really.  Until today ...
we got the results of Mavericks CBC and it looks like the platelets are finally kicking in.  Hooray!!!  Dr. Suter was right, they were just taking their sweet time.  They are at 20 from 8 and are clumping.  Clumping means that there are even more than 20 the machine just can't count them accurately.  However his WBC and RBC are down.  WBC is 1.7 down from 3, neutrophils are at 1320 before they were 2500.  RBC are at 27 down from 32.  Given these numbers Dr. Hazzah recommends a 10 day course of Zeniquin.

Other than all that Maverick is feeling great.  Everyday he feels a little stronger.  He has slept through the night four times this week.  It really feels like he has turned the corner.  It is just amazing.

We also heard from Suzi that Cody is happy to be home.  Cody has not been feeling well though.  He is very lethargic and having trouble walking.  Hopefully we will have a more positive update soon.

I also got an e-mail from Gary who said Molly (the 5th dog to receive the transplant) is home as of yesterday.  Molly is happy to be home but exhausted.

3/22/09

We just put a video up on the front page showing Maverick playing ball with Howie and his sister, Ruby!  We are now almost exactly 2 months after he got his bone marrow transplant and he is doing great!!

Also, at this point, we don't believe Maverick's got ITP given the latest results and we will be rechecking his CBC tomorrow so if things continue to look good, hopefully we can begin weening him off the Prednisone (the side effects are too bad to warrant him being on it longer than necessary - more aggressive behavior, excessive thirst and hunger, and some panting).

3/23/09

Just returned from our weekly, oncology appointment with Dr. Hazzah.  Maverick is doing fantastic.  His lymphnodes are normal, his weight is up, and he is just happy and playful almost all the time now.  We took blood for a CBC, results will be in tomorrow.  Also we decided to begin weening Maverick off the prednisone.  He will go from 40 mg daily to 30 mg.  In about a month we will be prednisone free, Hooray!!!

Just got word that Molly is doing great.  She is already bored to be home and wanting to go to doggie day care.  Her platelets are at 26 up from 17.  Molly is BMT patient number 5.

3/29/09

Unfortunately, Maverick's CBC results last week showed a drop in his platelets from 20K to 15K.  He almost certainly doesn't have ITP at this point.  His WBC and RBC counts are also down to the point where we are left wondering what the heck is going on with his marrow.  He is still on preventitive antibiotics and we are going to wait until the next CBC results (blood is being drawn for this tomorrow) before deciding whether or not to risk a bone marrow biopsy to help figure out what is happening.  The bone marrow bioposy would be the ideal next step to understanding the situation but it is potentially dangerous given his still low platelet count.

Overall, Maverick is still doing really well clinically despite his decrease in cell counts.  He is a little more lethargic than he was a couple of weeks ago, but he is eating well, playing, sleeping through the night more often than not, and acting mostly like himself.

Despite his low platelet count, we gave him and his sister Ruby some beef bones to chew on the other day and they had a great time with them out on the deck since it was almost warm and sunny yesterday.

This morning, we created a Facebook Cause page (the link to this is on this site's front page).  It's called "Save Companion Animals with Cancer."  We have had a great response to this and his Facebook page "Maverick the Weim" so far and hope to get as many people involved as possible.

We just posted the link to a great FOX news story done about Cody's BMT procedure at NCSU on our Media Coverage page and also to Dolittler (on our Resources page) - a fantastic veterinary blog site which is now featuring a blog on Dr. Suter's program.

3/31/09

Yesterday, Maverick had his weekly CBC and pathology review.  The results were not what we had hoped for.  Although his platelet count is up (to 20K w/ clumping which is better than it was last week), his RBCs are down, his WBCs remain low, and the worst part is they found a 6% population of lymphoblasts.  We are doing a bone marrow aspirate tomorrow to see what is going on.  Hopefully, this is just part of the post-transplant process and not a sign that his cancer is returning.  We will know the results of the bone marrow cytology, flow cytometry, and PARR later in the week.

The bone marrow aspirate is not something we'd ideally want to do now with Maverick's low platelet count, but we don't have much choice at this point.  Dr. Post will be performing it personally in his hip bone which has the least amount of tissue and muscle between it and Maverick's skin so there is the least chance of excessive bleeding.  Additionally, all precautions are being taken - with a coagulation catalyst being on hand and the emergency vet practice next door to Dr. Post's office having 2 bags of platelet concentrate in stock just in case.

We will post the results as soon as we know them.  Please keep Maverick in your prayers.

4/1/09

Maverick had his bone marrow aspirate today.  Thankfully, there were no complications.  We will have the results in a few days and will post them when available.

4/6/09

Sadly, we have to announce that Maverick's leukemia has returned.  We learned about this from the bone marrow cytology which showed that approximately 90% of the cells in his marrow are abnormal.  This is why his cell counts have been going downhill.  We have already started him on chemotherapy again (the Cytosar/Cytosar/Adriamycin protocol that got him into his initial remission) and are praying for him to have as long, happy, and healthy a life as possible.

He went in for a CBC and Superchem today and we will be getting the PARR results from the blood and bone marrow samples taken last week tomorrow night or Wednesday.  We expect these results will confirm that his cancer is back.

We are looking into Parthenolide as an alternative possible treatment (recommended by Dr. Post) and are also investigating whether there are other things we can try - a second bone marrow transplant using a donor, a second autologous bone marrow transplant if Maverick goes into remission again, higher dosage chemotherapy, and alternative chemotherapy protocols.

We will keep everyone updated, but probably not as regularly as we have been.

4/15/09

Maverick the Weim
has been having a rough few days. He's been in and out of the hospital and his oncologist's office and is now at home resting comfortably. He is being prepared for a final attempt at aggressive chemotherapy today or tomorrow. If that does not help, we will ensure he does not suffer. He is surrounded by those he loves and that love him the most at all times and he is an incredible fighter.  We will post the medical details of what has happened along with the treatments we are trying and the results (plus what we have learned and new connections in the oncology world we have made along the way) as we always have, in an effort to help others, once we get past all of this.