August 23, 2018 – When we arrived at NorthStar Vets, we were happy to see that they were not too crowded. As an ’emergency’ we were checked in quickly and spoke almost immediately with an intake tech. This facility is extremely well run – the entire process, from check-in to Lola’s exam was professional, thorough and caring.
Dr. Dorothy Jackson, DVM, DACVIM (Oncology) described what she saw on the x-rays that we brought with us. As we began to formulate a plan, we learned that primary lung tumors are rare in dogs and that there were many options for treatment. If a CT scan could confirm that the lesion had not spread elsewhere in the lungs (metastasis), surgery would be the treatment of choice, followed by one of three types of chemotherapy:
- Vinorelbine – an injectable agent given once weekly for 4 weeks, followed by 4 additional doses given every other week. It reaches a higher concentration in the lung tissue.
- Carboplatin – an injectable chemotherapy given once every 3 weeks for 4 total doses.
- Palladia – an oral, targeted therapy that attacks cancer cells because of a mutation they carry. It is administered at home.
As we tried to digest all of the new, strange terminology and options, Dr. Jackson remained patient and kind. We scheduled an appointment for Lola’s CT scan at the 8am the next morning. If the scan revealed a single tumor, we agreed that surgery would begin shortly afterward, while she was still under anesthesia from the scan. Dr. Jackson advised us to continue and finish out Lola’s Clavamox chewables, but to stop the Theophylline. Instead, she wrote us a prescription for 14 Hycrocodone/Homatropine 5/1.5mg tablets, to be used every 12-24 hours as needed to suppress her cough. This is normally a human prescription that is usually available at a regular pharmacy.
Throughout an almost sleepless night, I kept wondering if we were doing the right thing. Should we be putting Lola thru a major surgery to remove a lung lobe?
August 24, 2018 – Lola and I arrived at NorthStar a bit early so I could complete the necessary paperwork. When I was finished, a vet tech came out to bring Lola to the back to get her ready for the procedure; I kissed her on the head, “Be a good girl” I whispered with tears rolling down my cheeks. As Lola trotted happily away with her new temporary guardian I made my way back to my car to begin the hour-long ride home where Paul was waiting with Alvin.
Later that afternoon, we received a call from Dr. Jackson. “Lola’s CT scan confirmed the pulmonary mass, but did also show multiple nodules within other lung fields. We won’t be doing the surgery. We can start her first dose of chemo today – did you decide which one you want to use?”
We asked a few more questions, chose Vinorelbine and listened to the remainder of the instructions about what to expect. They also wanted to try her on an oral steroid, Prednisone 20 mg once a day, to help with her cough.
We were going back to NorthStar to pick up our good girl at 7:30pm! I was relieved. Lola was not having surgery and it seemed that the universe was gently guiding us – at least during this part of the journey.
. . . to be continued