So, Lion, our nearly 13 year old that is a cancer survivor for over 4 years now, **** (though it may be finally catching up with her), developed a corneal ulcer the other day. Sorry in advance if this is long.
She had recently been on a course of cancer treatment that was Chlorambucil and Dexamethasone (corticosteroid) for about 3 weeks after having been on Melphalan and Prednisone for about 4 weeks prior to that (Melphalan and Pred had worked before for some jejuenal lymph node swelling, but did not this time). After the Chlorambucil+dexamethasone treatments also did not shrink her lymph nodes but the weeks of high dose steroids basically wasted about 75% of her muscle mass and made her almost too weak to walk, we stopped that treatment as the cure was worse than the disease at that point.
After about 10 days being off the treatments she had started to make real increases in her strength and her demeanor was back to the dog we love. In fact, instead of lterally watching day by day as she got weaker and weaker, we were seeing her get stronger and stronger. I noticed Saturday AM, she had a fair amount of eye gunk in her left eye. I cleaned it but didn't think it was that unusual as both she and her brother seem to have more eye discharge this time of year, so they must have a mild allergy to something. We had a small gathering planned later in the afternoon so as I got ready I noticed maybe about 3 it was still getting gunky, but the eye seemed OK otherwise. We had about 12 people over for a while (friends and family she knows well) and she was fine with them, but had begun squinting some but seemed to be resting comfortably. I wiped her gunk off a few more times and by the time everyone had left at about 8:30, I noticed a spot in her eye. It was pretty small.
I started wondering if we needed to take her to the vet at that point and we figured we would plan to take her in the next morning if she wasn't better. I just had a nagging feeling and kept checking and about 10:45 it seemed like the spot had gotten bigger and the area around her eye was swelling so I just decided to take her to the emergency vet while my wife stayed home with the other dogs. I called and explained and they said bring her on by. So, I talk to the Vet tech there and they took her back just to look her over, check temp, weight etc and when she brought her back she said, based on what we are seeing, there's nothing we can do for her and you need to take her to the Vet School NOW. (we are lucky enough here to have the NC State College of Veterinary Medicine about 20 minutes from the house.) She called them and I could hear the concern in her voice and they got the Ophthalmology resident to come from home to meet me and Lion there. Its now probably 11:45 and they take us back. The resident comes in at this point, does a quick check and started getting really concerned. She went ahead and did a full eye exam, dilated her, put in dye, tested the Ph with strips that she stuck under her eyelids, used three separate light colors, etc to check her. Now, the ER Vet on call wanted to check and at least one student also came from home to see her. (one thing I have found about going to the Vet School for the oncology is your dog will never have a shortage of people to check them out)
So, she has a corneal ulcer that is part way through and in danger of perforating. Also, has some bad cells floating around in her eye and lots of inflammation (even since I had brought her it had increased.) The thought is all the immunosuppressive drugs she has been on along with the anti inflammatory corticosteroids caused her to not be able to fight off the bacteria and it got in on a scratch or foreign object that lodged in, but was gone by the time it was noticeable. They want to keep her overnight so they can give her drops every hour or so. She thinks there is a chance that she really might need surgery or else she is at risk of losing her eye. If that's the case, then we have a really tough decision to make as since her cancer status is not really known and we won't really be able to tell until she has an ultrasound Nov 6. We are just at the perfect time between the treatments and the ultrasound that they couldn't tell anything. So, we pretty much have to hope the medical therapy works as we don't want her last weeks to be in severe pain from losing the eye and with as much as we have done and spent so far, eye surgery just didn't seem like a good idea given her status, as much as we wished it were not so. So, I left here there at 2:30 Sunday AM knowing that we could be near the end with the sweetest loving dog you could imagine.
Next morning they call and say the treatments seem to be working. Eye is no worse, they want to keep her another full day. The other two dogs are super restless and mopey without Lion there as she is the alpha of the dogs and sort of keeps it all together. Get a call Monday AM, and I can immediately tell the Vet is happy. She said the eye looked so much better and that if we were up for giving her the drops we could bring her home. So, we go to the exam room to go over her treatment and the exam table is half full of the supplies. She has a serum that was spun down from her own blood to extract cells (I guess white cells? I forgot to ask. We have to use a needle to extract it, then take the needle off and use that as an eye dropper, drops that are an antibiotic, drops to dilate her hey as it was really constricted and spasming. Several pills to take, including antibiotics, tramadol for pain (they are afraid to use NSAIDs due to her liver). This is all in addition to the Denamarin and Alpha Lipoic Acid she is taking for the liver. Although 4 pills is not too bad, at one point she was on 7 a day, some AM, some PM and some both. We had to buy a pill keeper to keep track of them all. Basically, during the day, she needs drops every hour and at night, she needs them at midnight, 3 am and 6am. She is a trooper through it all and we have been up the last couple of nights like we have a newborn to give her drops. Now she knows that after she gets a drop, she gets a treat. That only took about 6-7 iterations. Its way easier to accidentally train a Basenji than on purpose it seems ;) And, even in just the 36 hours when was away, she got stronger, even with the eye thing. She is improving each day now and even is going in and out of the dog door with the e-collar on her! She just can't be stopped.
So, a lesson. If it has to do with the eye, don't delay treatment. They said that if I had waited until the next morning, we would probably be at a very different place.
****She had colon cancer and when they operated on her to remove 10cm of colon, they found a very small bump on her small intestine that never showed up on any of the scans or ultrasounds they had done, in fact they said they never would have found it if they hadn't just done some exploring "while they were in there". Turned out it was a plasma cell tumor. She had 4 rounds of IV chemo after the surgery and we gave her oral chemo for a while after that. She then went into remission, but eventually developed swelling in some lymph nodes and spots on her spleen and a couple of other things here and there. After more oral chemo for a few months, all that went away, then eventually, we got to where we are now, with two swollen nodes that are not responding to treatment, but have been pretty slow growing so far. Plus she has three liver values that are high, only one of which can be explained by the drugs, yet focused ultrasounds of the liver and biopsies show no cancer that is detectable. But, other than the initial recovery and up until this last month, she has been feeling great. No one would ever know she was sick and she runs around and plays with the other dogs like there is nothing wrong with her. We decided that as long as her quality of life was good, we would do what we could for her.