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Archive for November 1st, 2012

Dog Blog: Living with Canine Cancer (7) – Lou’s Special Recipes

Posted by indigodream on 1 November, 2012

Thursday 1st November 2012

Since I’ve published Lou’s cancer ‘diaries’, other people have contacted me for advice and support, as well as giving me support in return – it’s much appreciated. I’m often asked for recipes for a various things I’ve made to keep Lou fed and hydrated when she’s been at her most ill. So, for reference, here are some of Lou’s favourite dishes.

Now, here’s a caution, my hounds are complete dustbins, they do not have any allergies or food intolerances so I’m not worried about giving them dairy or wheat products. I do try to avoid salt and obvious dog toxins, like raisins/dark chocolate/onions etc; the jury’s out on whether garlic is ok – I tend to avoid it but they have eaten cooked garlic in leftovers and not suffered any harm. These recipes are intended as a supplement for sick dogs that simply aren’t eating and just need some calories; obviously they so make a nice occasional treat for other dogs who are getting a nutritionally balanced diet elsewhere.

In addition to the food, when Lou was suffering with radiation side-effects, black tea made an effective and evidence-based mouth/throat rinse (cooled and squirted round the mouth with a syringe).

I’ve also been asked about our experience with Lymphoma – it was a hard journey and I’m glad I blogged about it. Here are the links to the posts:

https://indigodream.wordpress.com/2012/07/18/dog-blog-living-with-canine-cancer-1/

https://indigodream.wordpress.com/2012/07/19/dog-blog-living-with-canine-cancer-3/

https://indigodream.wordpress.com/2012/08/05/dog-blog-living-with-canine-cancer-3-2/

https://indigodream.wordpress.com/2012/08/07/dog-blog-living-with-canine-cancer-4/

https://indigodream.wordpress.com/2012/08/10/dog-blog-living-with-canine-cancer-5/

https://indigodream.wordpress.com/2012/11/01/dog-blog-living-with-canine-cancer-6/

https://indigodream.wordpress.com/2012/12/06/dog-blog-still-living-with-canine-cancer-the-penultimate-chapter/

Special Recipes:

Liver Cake:

There are many many versions of this popular snack and training treat – here’s mine!

500g lamb or chicken liver (raw or boiled – the pre-boiled liver makes a ‘softer’ cake – see below)

3 eggs

Plain flour

Milk to mix

Liquidise the liver in a blender and put in a mixing bowl with the 3 eggs – beat well; add flour until the mixture binds to a ‘soft dropping’ consistency (splats gently off a spoon); if the mixture become too thick then you can add a bit of milk to get the right consistency. Turn into a shallow cake tin (a 9″ round sponge tin works well); bake at 180 degrees C for 40 minutes – depending on your over, you may want to give it another 10 – 15 minutes if still seems ‘raw’ in the middle.

Pre-boiling the liver gives a soft moist cake which is very good for wrapping round tablets if you need to give them medication!

Offal Risotto

Don’t worry about getting the right ‘al dente’ consistency – well, not unless your hounds are big fans of masterchef!

Doggie bread ‘n butter pudding – aka “Crime Pays”….

500g of offal – I use a mixture of heart, liver and kidneys depending on what’s cheap
Boiling water, home-made chicken stock or stock made with a low-salt stock cube
500g risotto or paella rice (paella rice is half the price and gives the same results)

Chop the offal into small chunks (about the size of a thumb) – put in a BIG pan and cover with a generous amount of boiling water. Boil the meat for 30 minutes until cooked then add the rice to the pan – simmer for around 20 minutes, topping up with boiling water regularly if it looks as if it’s running dry. The finished product should still have some liquid and the rice should be moist and sticky.

My friend boils finely chopped carrot with her meat for the risotto but Lou, Ty and Ollie don’t like carrots!

Liver Ice Cream

400g chicken livers, boiled then blended until smooth
Add 150ml double cream and whip the mixture until it starts to thicken
Chill the mixture
When cold, transfer the mixture to an ice-cream maker and churn until frozen (took about 10 minutes in my machine)

If you don’t have an ice-cream maker then you can put the mixture into the freezer and stir it every hour or so (to break up any crystals) until it is frozen.

Doggie Bread ‘n Butter Pudding aka “Crime Pays

Made when the hounds stole a loaf of my cooling home-made bread but didn’t quite finish eating it – I used the leftovers to make this:

Thinly sliced bread – enough to make three layers of your pie dish
Butter
2 eggs
three-quarters of a pint of milk
Handful of grated cheese
Handful of chopped cooked sausage e.g. kabanos, frankfurter

* Grease the pie dish with butter
* Butter the bread – put a layer of bread in the bottom of the dish, buttered side up
* Sprinkle some grated cheese and sausage onto the bread
* Add another layer of buttered bread
* Add another sprinkling of cheese and sausage
* Add a top layer of bread – buttered side up
* Warm the milk gently in a pan or microwave – do not boil!
* Beat the eggs in a large-ish bowl
* Pour the warm milk over the eggs and stir
* Pour the egg/milk mixture onto the layered bread
* Allow to soak for half an hour
* Bake in a moderate oven, 180 degrees C, for 30 – 40 minutes until ‘set’ and golden brown

Rice Pudding

3oz (around 100g) of pudding or risotto or paella rice

2 pints milk – I often use a mixture of double cream and milk to bulk up the calories

1oz (around 30g) sugar – you could use a tablespoon of honey or omit the sugar altogether; I like to put a bit of sugar in because I can steal a bowlful then!

Mix the ingredients in an ovenproof pudding basin; bake in a slow over 160 degrees C for 1½ – 2 hours until the rice is soft.

Offal Stew

500g meat – stewing steak, lamb’s kidneys, lamb or ox heart or a mixture

Flour

2 pints (approx.) hot water or stock

Chop the meat into small pieces and toss in a bowl of flour until the meat is evenly coated. Heat some oil in a pan (preferable a heavy-bottomed casserole pan), brown the floured meat then pour over the stock – stir until the mixture boils again. Allow to simmer for 1 hour OR transfer to an oven-proof dish and bake in a slow over (160 – 170 degree C) for an hour.

You can add vegetables e.g. carrots if your dogs like them; I sometimes thicken the mixture with a couple of chopped potatoes or a handful of rice.

Chicken stock for dogs

This basic stock does not have any seasonings – you can add vegetables such as carrots (not onions) if you want. The stock is useful for soaking food to make it easier to swallow or it can be used as a base for the risotto and stew (recipe above).

1kg chicken wings (you can use other cuts e.g. thighs/legs, but wings give a jelly stock)

Water to cover

Place the wings in a large saucepan and cover with water (cold or boiling); bring to the boil and allow to simmer for around an hour. Strain off the liquid and allow to cool – skim the fat off the top when cool. The stock can be stored for several days in the fridge or frozen for use later. The meat from the chicken wings can obviously be stripped off the bone and added to their food!

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Dog Blog: Living with Canine Cancer (6)

Posted by indigodream on 1 November, 2012

Thursday November 1st 2012

Hurrah!

Sleeping is a big part, sorry, the biggest part, of a retired greyhound’s day, so as long as Lou can enjoy her snoozing then she’s doing all right!

Today is our first cancer milestone – when we decided, back in May, to treat Lou’s cancer, we had hoped against hope that she would live long enough to get to her 10th birthday – and here we are!

I feel that there should be bells ringing throughout the county to celebrate, but the fact is that Lou’s life with cancer has been a rollercoaster ride. We lurch from crisis to crisis, but what keeps us going is the fact that in-between she is cheerful, eating well and  able to sleep comfortably. She can’t walk very far any more, but she doesn’t seem to miss her extended rummaging sessions and she’s never been one for chasing balls or playing with toys so I think she still has quality of life.

What I want to share in this post is our BIG decision to stop Lou’s maintenance chemotherapy – we’ve had to make a lot of decisions – each one has involved a very individual journey and only time will tell whether we’ve taken the right path…

When I last posted in August, Lou had an enormous ‘ulcer’ at the back of her throat which was infected with MRSA, but the good news was that there were no signs of the cancer in her throat. This suggested that the intensive phase of her treatment – both high-dose chemotherapy and radiotherapy had put her cancer into remission. Lou has been in remission for 16 weeks.

Of course, the cancer is only one aspect of Lou’s health, while we’ve been concentrating on that, we’ve had to pull back on the therapies that keep her arthritis under control. Because of interactions with her cancer medication, we’ve had to stop giving her anti-inflammatories; because of the cost we’d stopped her physiotherapy sessions. In addition, in the middle of August she developed a strange ‘blister’ on her shoulder, which promptly got infected with MRSA and, within days, was a full thickness ulcer which took the best part of a month to heal.

We can tell how well Lou is feeling by how close she lets the boys get to her – when she’s well they get sent packing – quite emphatically – but when she’s ill she can’t be bothered and the boys get to share the sofa and other luxurious beds!

Regular readers will have probably worked out that our “Autumn Odyssey” has been a bit fraught because Lou has had more than her usual levels of pain – mainly because she’s so stiff and clumsy on the boat steps. Eventually, though the blog hasn’t caught up yet, we cut our holiday short by a few days – this takes us up to September 21st and the start of the journey which has led us to withdraw her chemotherapy…

w/c 24th September:

Lou was extremely stiff and painful after our holiday – we had a long discussion with her vet, and with full knowledge of the potential risks, we took a chance with a 3-day trial of anti-inflammatories. The idea was to reduce the “achey” pain, which her other painkillers just don’t do, and reduce the inflammation in her joints. There were two main risks:

  • Anti-inflammatories interact with steroids and can cause serious gastro-intestinal side-effects e.g. ulceration and bleeding
  • Anti-inflammatories may interact with the methotrexate (chemotherapy cytotoxic i.e. cell killer) to cause all sorts of problems though many take them together without any problems.

Lou was already on a drug to protect her gastrointestinal tract and we hoped that this would be enough to protect her. We started the anti-inflammtory drug and, for 2 days, she was doing very well – her mobility and general cheerfulness improved. Then, on day 3, disaster struck – in the evening she became unwell and overnight she had several bouts of black tarry diarrhoea – the colour is from partly-digested blood and a sure sign of bleeding somewhere in the gut. I rang the emergency vet, who sleepily told me it could wait until morning – I was a bit vexed because I knew, from past experience, that she would be admitted and would rather have had them do it at 4am than worry about whether she was going go into shock from loss of blood before I could get her an appointment later on! Never mind, at 10am she was admitted to doggie hospital for fluids and treatment to patch up the gut ulcers and hopefully stop the bleeding. She was in for 2 days before being well enough to be discharged.

At this stage we HAD to take her off the anti-inflammatories,but we also took her off her cytotoxic (cell killing) chemotherapy; we had to keep her on the steroids but we swapped to an injectable form, which would be less wearing on her gut. For information, long-term steroids CANNOT be stopped suddenly as they have a profound effect on the body’s metabolism and rapid withdrawal can cause equally rapid death!

W/C 1st October & W/C 8th October

Sploshing is good – Lou loves to paddle!
We review our decision to keep her going about ten times a day – but as long as she can enjoy food, sleep, a splosh and lots of fuss we know she’s doing all right…

I’ll confess that after last week’s events I thought “this is it, Lou can’t recover” but within a few days of being home she was actually better than she had been since before the cancer was diagnosed. It’s probably no co-incidence that we decided to re-start her physio sessions around this time, in spite of the cost (don’t ask).

We then had an unprecedented 10 days without a visit to the vets! But on 11th October, I was back – Lou had signs of a kidney/bladder infection and we needed to review her medication and discuss our plan going forward…

Now, this next bit is ridiculously technical – I’m a pharmacist and I found it technical – but here’s the ‘dumbed down’ version of what Lou’s oncologists (chemotherapy and radiotherapy) and our vet concluded:

  • Lou had such an intensive course of treatment at the start of her condition that there’s little evidence to show that a few more months of maintenance chemotherapy would make any difference. Her radiation oncologist said that nowadays it’s not unusual for them to omit the maintenance chemo altogether if the intensive treatment has done its work.
  • The RVC oncologist said that there was no point in keeping going with the steroid if we were considering stopping the cytotoxics (long technical explanation to go with this – leave a comment and I’ll email you if you want it!)

But the decision was ultimately ours, so here’s what I worked out (with the help of Lou’s excellent local vet):

  • the urinary infection was treatable – he gave her an injection of antibiotic which is known to sting – Lou made the biggest drama ever and screamed the place down! She would need oral antibiotics for a week.
  • Her white blood count was lower than it’s been for a while – this may be because of the haemorrhagic gastroenteritis (the gastrointestinal bleeding that put her in hospital) but it may be because of the drugs – it does explain why she might have an infection.
  • The steroid might be contributing to the low white cell count, it’s also affecting her liver, and, this surprised us both, the oncologist says it might be behind the leakage of protein from her urine. This shocked us because steroids are used to treat leaky kidneys! It’s also the biggest barrier to using anti-inflammatories, which, at this stage, may be the more useful treatment. It will take a month to gradually withdraw the steroid!
  • She could stay on methotrexate (cytotoxic chemotherapy) but there is a potential interaction with the anti-inflammatory and is can cause blood in the urine (not helpful with her tendency to bladder infections) so we’ve decided to keep her off it for now.
  • She seems to get on ok with the Leukeran (her other cytotoxic chemo drug), which she has once a fortnight, and it has no interactions with her other drugs so we’ll keep her on that for now to potentially mop up any emerging cancer cells.

Lou’s cancer is so rare that there is no precedent from the research – this means that we can focus on her wellbeing. Withdrawing most of her chemotherapy means that we will be able to treat her arthritis more effectively, and that is causing her the greater problem at the moment. Of course, withdrawing the cytotoxics may give her a shorter remission from the cancer, but even THAT is not predictable – the radiotherapy by itself can produce remissions of 12 – 18 months – far longer than with chemotherapy alone.

W/C 15th and 22nd October

Lou’s birthday roach – hurrah!

Lou has been better in herself than she has been in months BUT I did say that we lurch from crisis to crisis – we’ve had to deal with altogether too many poo and wee accidents this week – all a precursor to her becoming very ill on Friday 19th – the vet said she had a temperature of around 104 degrees (in old money!) and obviously had an infection somewhere – not sure where, but the treatment’s the same regardless. We put her back on two types of antibiotic – she was so ill on Friday night that once more I though “this is it”. But by Saturday afternoon she’d perked up again and was back to eating, sleeping comfortably and taking an interest in coming for walks in the car (albeit her limit is about 15 minutes of bobbling before her legs start to shake). She was back to racing Ty up the garden, sleeping through the night without incident, eating like a small horse and on Sunday afternoon she insisted on coming for a more intensive walk with the boys and did really well.

I took her back for a checkup with a different vet on Monday, and although Lou seemed well in herself, the vet found that she now had a sore throat and a heart murmur. Lou was ill overnight on Tuesday so we went back to the vet today – the heart murmur has disappeared but Lou’s panting (especially after any exercise) was a concern. The vets are all worried – there are any number of things that might have caused her recent symptoms, but what we’re dreading, of course, is the return of her cancer. She has lymphoma, a cancer of the white blood cells, which may recur anywhere in the body, not just where it started in her throat. Luckily Lou is not bothered, although she has episodes of not feeling very well, overall she’s quite cheerful!

Lou spent the first half of her birthday begging nicely for food, but the vet had banned her from eating because she was going to have an anaesthetic in the afternoon – poor Lou! Then she was admitted for a scope of her throat and some x-rays – her vet decided against the heart scan – the murmur hasn’t reappeared and there’s not other sign of cardiac problems so we won’t worry about that for now!

She came home at 8.30pm and is flat out – she’s wobbly and sleepy after the anaesthetic and sore after being pulled around the x-rays, but she’s comfy on her bed and will be better by tomorrow (we’ve been through this a few times before!). Overall there’s good news – there is no sign of cancer (Hurrah!) but she still has that troublesome ‘ulcer’/plaque at the back of her throat, though it’s better than it was in August. The plaque is probably infected, she also has an infection at the root of one of her canine teeth and the x-rays show that her knee is seizing up with arthritis. But all that is manageable – especially when she’s withdrawn from the steroids and can start back on anti-inflammatories.

So, in summary, we have an ill dog but not a dying dog – I’ll take that as a win.

It’s not quite how I envisaged that we would celebrate her 10th birthday and our first cancer milestone, but hopefully we’ll be able to celebrate at the weekend when she’s recovered from the anaesthetic – we can then look forward to our next milestone – Lou’s “gotcha” day (6 years) on 20th December….

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