The Vaccine Experience

It’s been five long weeks since my last posting.  Aiden has been doing great . . . seems like his old self.  His hair is growing back in and he’s starting to look like the old Aiden.  He’s also acting like his old self.  He can run, jump, and play like he did before . . . even go up and down stairs.  I’m not keen on his rambling up and down 16 stairs with his mates since they all take 3-4 stairs at a time at a dead run.  The one time Aiden managed to make his way upstairs is when he bolted behind the gate before I could close it.  In fact when I saw a dog go by me so fast I thought it was Cooper.  Nope.  It was Aiden who made his way up the stairs for a short investigation then barreled back down before I realized who it was.  He’d probably do OK if he was going up and down by himself, but running with the pack at a dead run gives me “paws”–all we need is a broken front leg to make this adventure even more exciting. . . and stressful!!

As I mentioned in my last post, we began the autologous vaccine protocol on Christmas Eve.  It’s called the ECI treatment.  You can find out more about it at Tripawd.com (https://tripawds.com/2019/03/20/elias-osteosarcoma-immunotherapy-vaccine/).   It’s an interview Rene did with Dr. Jeffrey Bryan, Professor of Medical Oncology at the University of Missouri.  You can also find results of the study at https://eliasanimalhealth.com/results/.  This is a tremendously promising treatment for OSA.  Let’s hope it’s available VERY SOON to every dog facing this terrible disease!!

Aiden’s treatment began with three doses of the vaccine that had been created from his own cancer cells.  The doses were given a week apart.  There were actually four injection sites, one on each shoulder and one on each thigh.  After the third dose, we waited two weeks to allow his body to build a supply of antibodies.  At the end of the two weeks, Aiden went through apheresis, a process that removed a volume of blood which was run through a machine that separated out the T-cells and returned the blood back into his body. ( If you’ve ever donated plasma, you had it done through apheresis.)  A team from the group conducting the trial came to Dallas to actually perform the procedure.  They took the T-cells back to their lab and multiplied them; the super volume of T-cells were returned this morning, so Aiden was back at the oncologist’s office to have the infusion. Staring tomorrow I have to give him an injection of Interleukin-2 every 48 hours for five doses.  This will boost Aiden’s own interleukin, a protein made by white blood cells (lymphocytes)  to stimulate the immune system.  Interleukin-2 is a product specific to the T lymphocytes or T-cells. Between the increased number of T-cells and the additional interleukin-2, Aiden’s immune system should kick into high gear to kill the micrometastatic cancer cells floating around in his body before they can cause any harm.

Fortunately for us, this is not the end of our treatment choices.  Since we have completed the protocol, the oncologist wants to go ahead and complete a round of chemotherapy–five doses, one every three weeks.  That will probably start at the end of February.  Blood work and x-rays in a couple of weeks will tells us if Aiden is still ahead of the game like he was six weeks ago.  The oncologist is VERY optimistic.

Sitting for hours in the clinic waiting on Aiden I have learned that there is great hope for our furry children who have been diagnosed with cancer.  I have met so many pet parents whose babies have gone into complete remission and stayed there for years.  Today I met a beautiful Golden who, at thirteen, had beaten lymphoma. I have also learned that there is hope that one day a cancer diagnosis will not be a death sentence for our fur babies.  That day seems a lot closer today than it did at the beginning of Aiden’s Great Adventure.

 

Days 9-12 Post Op What’s Next?

The last four days have been fairly easy.  Everything has pretty much gotten back to normal . . . until Sunday.

Before I left for church on Sunday, I put a t-shirt on Aiden, made sure it was tied so he couldn’t get his muzzle under it to lick on the sutures.  When I got home, he had gotten the t-shirt off his front leg and had worked it down below the sutures and had pulled out 3 stitches.  I’m still trying to figure out HOW he managed to do that.

So today (Tuesday) we are at the oncologist’s office to have the rest of the sutures removed.  The place where he pulled the stitches has opened up and is now infected, so we are looking at antibiotics and probably a return to surgery on Thursday to re-suture the open spot.  It has been a real battle trying to keep him from licking.  I’ve used a collar and a t-shirt, and he can still figure out a way to get to the sutures, and not just with his mouth but with his back leg–to scratch.

So we are going to try a hard Elizabethan collar, bandages, and a harness to cover the area until Thursday–and beyond–until the place heals.

In other news, the autologous vaccine protocol starts today.  This is all new to the staff at the clinic, so we are all going to learn a lot about this protocol over the next month.

I’ll keep you posted.  Merry Christmas to all the Tripawds out there . . . and their families!

Days 7 and 8 Post Op. The Light at the End of the Tunnel . . . It’s Not a Train!

These last two days have been great for Aiden.  He’s spent more time with his pack mates which has made a difference in his behavior; it’s really been great for all of us since we’re getting closer to normalcy.  I left the gate open the last two days–as well as last night–and, as expected, Aiden stays pretty much where I am.

The surgery site looks really good, but I think it must be itching.  He has a big Y-shaped incision so he has a lot of stitching.  He’s either wearing a soft Elizabethan collar or a t-shirt to keep him from licking.  I think he likes the t-shirt more because it is definitely softer than the collar.  Whenever he’s wearing the collar he has figured out how to get his muzzle underneath and lick the lower end of the suture line–the bottom of the Y.  The t-shirt covers better and prevents the licking.  I know he’ll be glad to get the sutures out on Tuesday.

I’ve cut back on the Gabapentin to twice a day.  I did give him Tramadol before bedtime last night, but I’m not sure he needed it.  He still whines occasionally, but it doesn’t last but for a few minutes. . . and he still only does it when I’m in the room.

It’s been funny to watch Sydney.  She likes to lay next to Aiden and let him lick on her.  And today she brought him one of her toys and laid it next to him.  It’s like all of them sense that something is going on with him because they have been calmer when they are around him.

I believe we have reached a milestone these last two days.  The impish, goofy Aiden is re-emerging and his confidence is growing.  Curbing his activity level is going to be a challenge, but nothing we can’t handle.   We are about to hit 9 days after surgery—I’ll take these last 9 over the 9 before surgery with all of the uncertainty and stress.  We’ve come a long way these last 18 days.  Our biggest challenges are behind us, and we are facing a very bright and promising future.

Aren’t our Tripawds amazing!!

Day 6 Post Op –and Hitting a Speed Bump

Day 6

Day 6 started out with unrelenting whining . . . at 1:00 AM.  For the next six hours I was on the floor next to Aiden trying to reassure him through the whining.  After speaking with the vet, it was decided to adjust his pain medication to Gabapentin three times a day and Tramadol before bedtime.

He slept most of the morning, but by the afternoon he seemed to be feeling like his old self again.  He sat in my lap for an hour watching landscapers put in new flowerbeds in the front of the house, barking every once and awhile to let them know he was watching.  He is also showing his dominance again–stealing a chew toy from Sydney with a bark and the snorting, bear-like growl he does.

We got good news from the vet.  The biopsy confirmed the diagnosis of osteosarcoma (which we expected) but the lymph node they removed from the shoulder showed no obvious signs of cancer.  Of course we know that there are cells wandering around his body, but we are going to begin the attack on those cells next Tuesday.  The sutures will be removed two days earlier than we anticipated and we will begin the immunotherapy on Christmas Eve.  What a great Christmas present for both of us!!

I let Riley in the “infirmary” with Aiden this evening just to see how she would react. She wagged her tail and walked carefully by then lay down about 6 feet behind him.  I don’t think she was too sure of what to think about it all.  When I went to the gate about ten minutes later she wanted out.  Cooper is dying to get behind the gate, but he and Aiden–although they never fight–do a lot of growling and posturing with each other. . . they have ever since they were puppies.  I think they both can do without all of that until next week.

Aiden seemed comfortable all afternoon.  He went out several times, making it look so easy maneuvering on 3 legs.  His appetite continues to be normal.  I’ve given him two doses of Gabapentin and will give him a 3rd before bedtime along with the Tramadol.  Hopefully he will sleep through the night.

Observations on the Whining

About 6:30 tonight Aiden started whining again.  I was sitting in the study and he was laying in the hallway about 8 feet away.  The vet said she was surprised by the whining five days after surgery, so it got me to thinking that there might be another reason for the vocalization–Aiden has always been a vocalizer when he wants something and either can’t have it or can’t get to it.  Tonight I noticed that he was only whining when I was nearby.  When I went into the kitchen, he quit whining–something I don’t think he’d do if he was really in pain. He’s been isolated from the pack for 5 days now so I wondered if he was showing his frustration.

Tonight when he started the whining, I whined back.  The more he talked, the more I talked back.  In a few minutes he got up and hopped into the study and started wagging his tail and butting me with his nose–things he always does when he’s in a playful mood.  After some snuggle time, he curled up beside my chair and went to sleep.  He’s been quiet for the last three hours.

I think pain probably was part of the reason for the whining early this morning, but I think maybe he’s getting just a bit tired of the isolation and the lack of freedom. I may try some more socializing over the next few days to help him out.

Six more days, Aiden, and things will start to look up for you!

Days 4 and 5 Post Op–Turning Corners

Day 4

At 1:00 yesterday the Fentanyl patch came off.  It must have been itchy because Aiden really licked where the patch had been!  His appetite was still great.  He was even back to his old self when it comes to to his love of tissues and paper towels. . . and his predilection for toilet water :-/.  It’s so absolutely true what they say about Goldens….everything goes in the mouth!

He was still peeing a lot yesterday.  The area of visible bruising had gotten bigger, but that was expected.  The swelling has gone down which is great!

Day 5

Today is the fifth day post-op and I have seen a noticeable uptick in Aiden’s activity level.  The Gabapentin still makes him sleepy, but he seems more alert than he has been. He’s not having to pee near as much either.  The tape and bandages that were covering his sutures have all disappeared so he is now sporting a new green t-shirt to help keep the area clean and to keep him from licking.  He and Sydney are spending more time together, and we’ve all gotten used to the new routine.

I’m keeping a close eye out for any signs that his pain level is going up because of the absence of the Fentanyl.  So far he doesn’t seem to be in any pain. . . no whining, no heavy panting, no restlessness.  That could change, so I have a supply of Tramadol just in case he needs it.  I have to give a shout out to the oncologist and our vet who have both been way ahead of the game on this.   Couldn’t have asked for a better team!

Awww-Moment Side Note

I have a recliner in the room where Aiden is staying.  I’ve been sleeping there because the only bed with mattress and box springs is upstairs.  I had just finished renovating my house when Aiden was diagnosed, so the house is still is in a bit of a chaotic state, and the bed downstairs is just a frame. . . mattress won’t be delivered until January 7.  The weather has been cold the last few nights so I am using a heated throw as cover.  After I had barely gone to sleep I felt one foot . . . then two. . . then three.  For the next hour or so I shared the recliner with Aiden.  I think he really enjoyed that heated throw!