Meesh

Hamlet is back down at Penn today for his third chemo treatment. The oncologist just called me with an update. Last week, his liver panel showed one of his enzymes – ALT – was elevated after everything else went down to normal levels. This week, the liver panel showed the same enzyme went up yet again but all other enzymes being within normal range and his liver function looks good. His blood work also indicated that his red cells have increased and the white cells are good. Since the single liver enzyme going up has everyone boggled (I asked if they hadn’t seen something like this before and the onc said not really and the only time she had experienced it was in cats with glandular hepatitis), they said it could be due to several reasons: 1. the pred could be elevating it but that seemed unlikely since we actually reduced the dosage last week and had him on a liver protectant, 2. it could be that the lymphoma is just in his liver so much that that’s the reaction, 3. it could be an infection or glandular hepatitis.
The treatment, Vincristine, we skipped last week and were supposed to get this week metabolizes through the liver so the onc went over several options with me: 1. go forward with a lower dosage of the Vinc plus send me home with a liver antibiotic for the week, 2. do another ultrasound but she said she didn’t expect that it would show anything too different from what was indicated on the first one, or 3. do a liver aspirate which would require sedation. We both agreed to go forward with option 1 and if the liver enzyme still looks wonky next week, then we’d do the aspirate. Plus, if the enzyme elevation is due to the lymphoma, getting the chemo may actually be what’s needed.
Otherwise, Hammy’s been eating like a little pig and acting like his normal lovey self. He was wrestling with my parents' dogs Foxy over the weekend and even picked a fight with Rufus over a sofa spot last week. So, we’ll just have to keep our fingers crossed that the liver thing is nothing additional to the lymphoma and that the chemo will address it.

Benpaws

Thanks for the "update" Michelle. Hopefully,the liver antibiotic will do the trick and bring the enzymes back down.

It is a very good thing that Hamlet is eating well and playing and just enjoying being a dog. These are all very positive signs and we are all glad to have this news.

Keep on keeping on.

Blessings,
Joanne & Shadow

rockytola

I agree with Benpaws.....any time the little rascals are going gangbusters around the house is a good sign. Hugs and kisses to your rascal. One word of advice....every day take his head in your hands, cuddle his ears and put your nose on his. Look deep into his eyes and tell him you love him. It's good therapy for both of you!

TJandDante

Sounds like the dog is doing very well with the treatment, and if the liver was having bad oriblems, all the liver enzymes would be screwed up, not just the ALT. (At least that's true in humans).
Your dog is telling you he's feeling well-the fact that he's playing Alpha dog with places on the couch is a great sign.
I'm so happy for you and Hamlet! Keep us updated.
TJ

Meesh

Thanks, everyone. I'll be sure to keep the weekly updates coming.
TJ, the onc basically confirmed as you mention when they "de-briefed" me when I picked up Hamlet last night. She said that while they want all the enzymes to be within normal range, the ALT is the least important of the enzymes.
And, I almost forgot...it seems that the embarrassing little issue he's been having that I posted about last week is all food related; it seems to only be occurring at those times he's expecting a treat or his meal. As you say, Joanne, I guess he is just REALLY HAPPY about getting his food! LOL

Michelle, Rufus & Hamlet (dx 01/29/10 tx 02/01/10)