Jill's Journey

WAKE UP MOM ITS TIME TO GO TO THE DOCTORS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Today Jill had a check up at the oncologist after being on metronomic Leukeran (Chlorambucil) for 3 weeks.  First up was the chest X-Ray.  The oncologist thought it looked A-OK, but doesn’t like to give the “all clear” until she has the radiologist look at it.  So I had to sit and sweat it out until he got around to it SEVEN HOURS LATER!  Bottom line, he agrees, ALL CLEAR.  PHEW!  What beautiful lungs you have Miss Jilly:

Next up was blood work and physical exam.  Physical exam was great, she looks perfect (obviously!).  Blood work.  Well….no surprise here…..WBC, neutrophils and lymphocytes all low, but nothing too low that we need to stop the leukeran.  So we continue on.  She will have blood work now once a month to make sure all her levels remain ok and another chest x-ray in 6 months (I’ll never make it that long…….but we’ll see!).

She has been a bit lethargic since starting the Leukeran, but the oncologist says it’s probably just a side effect and as long as she’s eating, using the litter box and grooming herself, she’s ok, unless its so bad I want to stop it.  For now, I think we’ll keep on keepin’ on!

By the way, I have NEVER seen Jill as nervous as she was today.  Maybe she knew she had a big test today!  I swear I was behaving totally normal.  She was panting like crazy on the way to and from the hospital.  Never seen her do that before!  And she is totally POOPED TONIGHT!!!!! Ta Ta for now…..must go rub this exhausted kitty’s belly….

One year ago today, June 27, 2012, I was sitting in my office, nervously waiting for the vet to call to tell me whether Jill’s lungs were clear and if they could proceed with the toe amputation.  I did not know at that moment, it would be the first of many times during the next 12 months I would be waiting for the “all clear”, all I remember is sitting at my desk, staring at my computer screen in a full daze.  I got the phone call around lunch time and off she went into surgery to get her little toe chopped right off.

So, today, we celebrate Jill’s ONE YEAR TOE AMPUVERSARY!!  It may seem silly to celebrate this, however, as we all know, Jill’s osteosarcoma journey has taken quite a different route than most cases.  When most celebrate their leg ampuversaries, we often think it’s how long they’ve been battling this nasty disease, however, Jill didn’t have her leg amputated until 6 months later.  So I officially look at June 27th as the day Jill started her fight, thus she has now been fighting and BEATING Osteosarcoma for ONE YEAR.

It’s been a roller coaster ride, for sure.  A ride filled with tears, laughter, paranoia and love.  So to celebrate Jill and how tough of a little diva she is, I’ve put together this video montage set to tune of two of the greatest divas of all time.  I hope you enjoy, make sure your volume is on! 🙂

Some pictures from June 27, 2012 and the week after and present day:

Jill Here.

Hey, guess what!?  My grandmaw and grandpaw went on a vacation again and we get to watch Belle for two whole weeks! AND thats not just all she is spending her BIRTHDAY with us! Today is my best friend Belle’s birthday!  She is a whole two years old today! I love you Belle.  You are a great pal.  You help me get good exercise by chasing me around, which is good for keeping me healthy and you also snuggle really good and you never ever bother me while I am trying to nap…

Mom let us celebrate by letting us wear fancy hats.

On June 27, 2012 Jill had her toe amputated and thus, began our osteosarcoma battle.  In honor of her and to celebrate ONE  YEAR of fighting and BEATING this nasty thing, I have put together a little tribute video, however, you will have to wait until June 27th to see it :)….In the meantime, I thought I’d give everyone a little teaser….

It was one year ago tonight that I came home from work to find Jill finally out from under the bed after hiding there for two weeks.  It had been the first time my parent’s puppy Belle was visiting, so I figured she just wasn’t a fan (now we know different, as they love to play).  I scooped her up, and soon saw the reason why she had been hiding for two full weeks.  What I saw shocked me (warning, this photo is very graphic, so scroll past it if our stomach is weak!):

 

I honestly thought Belle had bit her and she retreated under the bed for two weeks and allowed an infection to set in.  Looking back on what I did next seems so silly, but at the time, I thought it was the right thing to do before I could get her to the vet!  Yes….I put neosporin on it.  I wasn’t able to get an appointment until the next night, and I honestly thought she got a bad boo boo on her foot, so off to work I went the next day and off we went to the vet the next night.  Just to show you I’m not totally crazy, the vet suggested we treat it as an infection with clavamoxx and soak in twice a day in a solution for a few days.  So even she thought it was an infection 😉

But……….5 days later, it was no better.  Off we went, back to the vet for a fine needle aspirate….and from there, it seemed, everything fell apart.  This was no infection.  This was cancer.  What kind?  We don’t know yet, but that toe HAS to come off immediately.  So we scheduled her toe amputation for June 27th  (which we will be celebrating as her toe ampuversary this year and a year fighting cancer!) and they will send the toe off for a biopsy…….WHAT IS GOING ON!? SHE JUST HAS AN INFECTION!!!!!…………

And here is my poor Jilly suffering through those five days, so she didn’t lick her “infected” toe, I have to say this was the most miserable she was throughout this entire year – a toe amp, a leg amp, chemotherapy………the cone made her the most miserable

Jill Here.  There are many Mommys on here, so I just wanted to give a quick shout out to the often forgot about fathers and grandfathers out there on this Father’s Day. HOPPY FATHERS DAY to all the tripawd Dads and Granddads.

I love you Grandpaw, thank you for everything you have done for me this year.

Here is a pic of me and my grandpaw at the oncologist.  Isn’t he the best?

Love,

Jill

Amputation: Check! IV Chemo: Check!  Now onto Metronomic chemotherapy…….

My biggest hope in writing this blog post is that it will help another kitty mom one day, if they find themselves in the same situation that I find myself in.

A brief background as to how we came to the decision as to why metronomic chemotherapy is the right path for Jill as this time:

OSA in kitties does not spread as rapidly as it does in dogs, so in almost all situations, when a kitty gets OSA, they amputate the leg and that’s it.  No chemo of any kind is recommended.  Jill’s case, however, presented differently.  Her primary tumor was in her toe and her toe was amputated (upon amputation, clear margins were achieved, so no further treatment was recommended).  6 months later, however, a met appeared under the skin (not in any bone) in that same leg.  So, we know Jill’s case spreads more rapidly than it typically does in a cat.  Her leg was then amputated as we all known and then she was treated by four rounds of IV chemo (2 rounds of carbo, 2 rounds of doxorubicin, alternating the two).

Since I have learned so much about metronomics on this site, I brought it up to her oncologist, and we decided to give it a try.  Jill’s bone marrow has had a rough time bouncing back from the IV chemo, it is now 12 weeks later and her white blood cells, specifically her neutrophils, are still on the low end.  We know from CBC’s done prior to chemo that she has naturally low neutrophils, but they are still lower than “Jill normal”.  Since this is the case, instead of cytoxan (Cyclophosphamide), which many with OSA are treated with metronomically, Jill will be taking Leukeran (chlorambucil).

I absolutely love Jill’s oncologist and trust every recommendation she has given us.  However, the problem with Jill’s rare tumor, as I stated in my previous post, is that there is just no research, case studies or information on treatment.  So once or twice, her recommendation has really been: “we just don’t know”.  This can be confusing, terrifying and maddening all at the same time.  So we’ve chosen this path, knowing that we can stop the Leukeran at any time, with the best information we have, which unfortunately, is really no information at all.

So my goal is that one day, someone will google “cat metronomics” and my blog will pop up and offer someone some hope and information.  Jill is my hero, and hopefully one day, she will be another kitty’s here as well.

“What is this…..and what are you planning on doing to me??????”

Update: Just gave Jill her very first dose of Leukeran.  Was a little nervous as it comes in a capsule and I’ve only ever given her small little pills before.  She is obviously very mad at me now and not happy about this (read: sarcasm):

Wow.  6 months already?  How did that go by so fast!?  When I sit down to actually look back on the last 6 months, I really only see improvement after improvement and belly rubs and purring and kisses.  Not any recovery, CBC’s after CBC’s after CBC’s, x-rays, chemo, vein problems, peeing issues, supplements, metronomics.  And I think that really says it all.  6 months is also quite meaningful for us, because it was 6 months after her toe (where the primary tumor was) was amputated that it metastasized up her leg.  So, to get to this point is very important to me.  My little ten pound One of a Kind is an inspiration to me everyday and amazes me with the amount of typical cat-like ambivalance she has had toward cancer and having three legs throughout this entire journey.  Six months ago, I was worried this would ruin her life.  How silly.  When we go to the vet and she gets handed over to the vet tech, she still wraps her arms around that tech’s neck for a big hug, just like she has her whole life.  She hops around the apartment as if she’s been a three-legged kitty her whole life.

So.  Happy Ampuversary my Jilly.  I am so so proud of you and love you!

December 15, 2012 (3 days post amputation):

June 13, 2013 (6 months later!):

One year ago this month, I brought Jill to the vet for an “infection” on her toe.  Everything seemed to turn upside down, topsy turvy real fast from there.  While we’ve been on our tripawd journey for almost 6 months, it’s been almost a year (celebration to come in a few weeks) that we’ve been on our Osteosarcoma journey.  To tell you the truth, I was so lost when I got the diagnosis, that I’m writing this post in the hopes that ONE DAY, it will help someone.  I know I have helped a few kitty tripawd pawrents, but one day, I hope someone who is in need of feline osteosarcoma information, even more specifically Giant Cell Osteosarcoma information, will find some hope here.

It is not a pleasant thing when a pathology report comes back and all the vets say to you, “we’ve never seen this before”, so now, one year later, I’ve chosen to change that school of thinking, and just call Jill “One of a Kind.”  She is, of course, one of a kind in many other wonderful ways, but this just adds to her unique wonderful kittiness.  When I was thinking about writing this blog post, I went to google some studies, to see what kind of information I could show, besides just saying: “OSA is rare in cats”, so to give you an example, in one study done in 2007  of the “Diagnosis and Clinical Outcome Associated with Surgically Amputated Digits” (85 cats in the study) the following was stated (GCTB = Giant Tumor of the Bone, what Jill has):

“Of note, were the 2 GCTBs diagnosed in this study. This is a rarely reported neoplasm in domestic animals, and few reports exist in cats.  The relative frequency of its diagnosis in the digits in this study was unexpected, as GCTB has never previously been reported in the digits of cats and is uncommon in humans. Only 13 cases of GCTB were seen in the hand in a retrospective study of 50 years of submissions at the Mayo Clinic.  Typically, this tumor is reported to occur primarily in the epiphysis of tubular long bones in humans and animals, and reported cases in cats originated in the femur, ulna, rib, and tibia.”  As I said.  One of a Kind.

So, when your pet is One of a Kind, you’re faced with many challenges.  The hardest being that sometimes you’re given many treatment options and the vets leave the decisions up to you with no data at all to back it up.  I was presented with this:

“We could only find 2 cats ever to have Giant Cell OSA and they were both in Germany and no follow-up information was done on them, so we do not know what treatment they were given.”  OK…..so what do I do?  Well, I was told, “we can do chemo or just keep an eye on her since she got good margins, but we really can’t make a good recommendation as to which is better, you have to decide what you’ll be able to live with”

Hmph.  From here, I decide to keep an eye on her.  Then 6 months later, she got the met in her leg.  Do I have regrets?  Mostly, no.  There are some days where I question my decision, but I can’t go back, so what’s the use in looking back.

Now I find myself one year later with more decisions being left up to me.  Metronomic chemotherapy, as far as they can tell, has not been given/studied in cats with OSA.  Since we know Jill’s cancer is a bit more aggressive than others, we want to give it a shot.  But her bone marrow seems to be having a hard time recovering from the IV chemo, so do we give her a type that is easier on the bone marrow?  Who knows?  No one…..

It’s a frustrating thing this One of a Kind business.  But it’s what makes my Jill who she is.  She doesn’t know about her diagnosis.  She’s never questioned my decisions about her treatment.  She hops around day after day living her wonderful, happy life.

Did I choose the right chemo?  Who the heck knows?  Should I have done chemo last June?  Who the heck knows?  Should we have amputated her leg last June?  Beats me!

One thing I do know the answers to is this: Will all my googling cure her?  No.  But I do have the hope that ONE DAY, be it 5, 10, or 50 years from now, someone will google “Giant Cell Osteosarcoma Feline” and my blog will pop up first, and my One of a Kind cat will help someoone out and give them some hope.

And now, because you can’t have a blog post without a picture, here is my One of  a Kind:

Well the Neutrophils are still low, but Jill’s been a busy girl this weekend growing new whiskers!  Ta da!