Leo finished round 2 of chemo on Saturday - his WBC was up to normal levels, so he did the last of the 4 drug cocktail that should, we hope, put him in remission. Now he has 2 weeks (and then some) off to recover, let his body heal and to let him be a happy Leo. Of course, right now, he's not so much a happy Leo. This last round was tougher on him, and it has taken some of his appetite - and caused some hair to fall out!
Actually, there's both hair falling out (I find it around my house, in little clumps, when he stays here), but it also grows back very slowly. In his initial diagnosis, he had his belly shaved for an ultrasound. It's still rather stubbly, and isn't growing back quickly. He has some bald patches on his legs, as well, and those are staying that way.
More troubling is his lack of energy for food. It's not a true loss of appetite - he grubs, begs, and still eats, but with much less enthusiasm than he had before. Bally is not his favorite thing, anymore - he needs something more than just the tricky-treat ball to keep him going now. I hope his gusto for food returns - or at least his love of Bally. He loved it so much that he used to take it to bed with him - both his bed (allowed) and my bed (not allowed).
Today, Bit started his chemo - Prednisone (well, prednisolone, a better-absorbed breakdown product of prednisone) and Leukoran, a mild, well-tolerated and every-other-day oral chemotherapy drug. Let's hope that does some good, and that it (slowly) gets his tumor(s) to shrink. I had to make a call on what protocol to use, and this seemed like the best for him, given his age, current strength, tumor load, and potential side effects.
See, this was the decision i had to make - IV chemo, powerful oral chemo, or this route (or nothing at all, really). IV chemo was a non-starter - once a week in the office with needles - not this cat. That would have done nothing for his quality of life, and his personality simply does not allow for that sort of vet commitment. With Leo, it's easy - he goes in, they give him chicken, stick him with a few needles, give him more chicken, and he comes out happy. Hell, he likes the people, the car ride, the new neighborhood, all of it, so to him, it's not traumatic. Just putting Bit in his carrier is a whole production, and causes whining, crying, pooping, hissing, and all manner of complaining. The car ride makes him ill, nervous and uncomfortable. The vet office is terrifying, and he doesn't like being restrained, let alone poked and prodded. He's destroyed many an exam room, and the cat has been politely un-invited from several of the vets in Brooklyn (for real - he was asked not to come back un-anesthetized to several vets. When I say he's bad, he's bad).
The powerful oral chemo was probably the most aggressive possible treatment, but there was one bad side effect - if it worked really well, it was going to kill him. Because the tumor on his colon is rather large and involved, if it were affected too quickly, his colon could lose containment, causing waste to leak (in large amounts) into his abdomen. This would quickly lead to sepsis, and then death, with essentially nothing I could do about it. The Leukeran, while still chemo, is much milder - so much so it may not actually do anything to the tumor- but it will not kill him. The action is much slower, so that as the tumor is (hopefully) destroyed, his colon will have a chance to heal, maintaining it's integrity. Of course, if it is not effective, the tumor could cause his colon to rupture... So it's really a question of how to approach this. The prednisone/nisolonononone will definitely have some effect on the tumor, shrinking it some. Hopefully, with some luck, the Leukeran will do it's thing, and his tumor load will, for a time, decrease. And it's well tolerated, which is important. So while the most aggresive things (surgery, IV chemo) aren't being done, what is being done is best for his quality of life. Again, that sucky phrase.
Although my quality of life is going to seriously suffer. This cat becomes a monster on prednisone - the appetite, the thirst, the activity. But if that's what it takes to get a year of Bitter, well, i'm on board.
Also, anyone need a website?
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