Re: Spencer and my talk with my Internist

[Lernermichelle]

Oh, Nina.  It's so good that he came home and is not in pain, and so awful that he has lymphoma.   I disagree that the depomedrol would be redundant with the dex, though I agree that pred would be.  The Depo is strong and long-lasting, and allows you to give the dex less frequently (dex is very strong).  The combination really seems to work well. But if she were going to give you only one of them, I do think the dex is probably the more important one.   I know you don't want to do chemo, but you might at least try the first kind that they give. It is a sub-q shot called Elspar.  It sometimes shrinks lymphoma quite a bit with the one shot, and maybe she would let you give the shot at home.  It is the one chemo drug with no side effects, as its only action is stop lymphoma cells specifically from reproducing.  Lymphoma cells die quickly and if they do not reproduce the cancer shrinks. In normal chemo regimens Elspar is followed up a week later by different and stronger drugs like Vincristine and Adriamycin, but I would think it would be better on its own, with the dexamethasone, than no chemo at all, and might be a good compromise since it is not stressful to give and has no side effects.  Mediastinal lymphoma, which is when it is where it is on Spencer, does tend to respond better to chemo of all kinds than other lymphomas.  So I would at least try the Elspar if you can, along with the steroids. I am not sure, but I think the Elspar is not that expensive either. But I could be wrong. One of the chemo drugs was very cheap, and I can not remember which one. It might be the vincristine.  Anyway, that is just my thoughts -- I am not sure whether a vet would even agree to do just one round of chemo, or to use just one chemo drug (though steroids are a form of chemo too, Simon's oncologist kept telling me).   Bless you and Spencer, whatever you do.  You will always know that he came home to you, and that is something quite large in itself.   Michelle   In a message dated 9/7/2006 5:23:00 P.M. Eastern Daylight Time, [EMAIL PROTECTED] writes: Hi Guys, First I'd like to apologize for not keeping up with the list and offering support as usual.  Life has been quite hectic/draining around here as you can imagine and I just haven't been able to.  I appreciate your allowing me to be selfish in leaning on you when I'm not reciprocating.  Maybe some of what we're going through will help others too. Here's the latest on Spencer...  I talked to my beloved Dr. Ortega this morning.  She understood why I am reluctant to put Spencer through more vet visits and further testing.  She did suggest that Spencer be pts, but understood and respected that I felt Spencer was not ready for help in crossing over.  She wanted me to understand that even with the most aggressive treatment we'd only be buying him weeks or possibly months, (as if I'm not aware of the usual scenario).  I told her I did not want to bring him in and begged her to use her intuition and expertise to help me find a way to possibly put him in remission, or at least make him more comfortable, (without bringing him in).  I asked her about injections of dexamethasone, depomedrol and about using Prednisone, (thank you Michelle!).  She prescribed the dexamethasone, to give him once daily.  She thought the other steroids were not necessary and would be redundant.  She also advised me to bring him in to drain whatever fluid might have built up since Monday night.  (I'm not bringing him in if I can possibly help it).  Her logic was, if the dex helps stop the progression of the cancer, it will also stop the fluid build up and he'll be better off if he starts treatment with it already drained. I asked her about a diuretic and she didn't think it was appropriate in this case and would probably only serve to dehydrate him.  She also said that it's possible, if things go very well, the fluid that's built up now could be absorbed on it's own.  His breathing is not labored, it's shallow and rapid, but not labored.  If he begins to have trouble breathing, I'll figure out what to do then. So, that's where we stand.  I gave him his first shot about an hour ago.  He asked to be released from the bathroom, so I let him out, (shutting the back door this time).  He's only had a handful of Wiskas treats, a tiny bite of salmon and a tablespoon of cream with BioPlasma in it.  As far as I know he didn't eat anything else since Wed morning, and only a touch of baby food then. I did talk to a couple of ACs this morning and they confirmed that he came back for me.  Jasmine said he had a "near death" experience and came back because we have "unfinished business".  The other AC said that he asked that I spend designated quiet time alone with him in meditation, that he wants to share his experience with me.  They also said that he wanted me to know how much he appreciates everything I've done for him.  His coming back to me is sure an indication of that! Keep those prayers coming! Nina