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Paraneoplastic Syndrome and Hypercalcemia

Our 11 year old bitch Luna had blood tests on Friday as she was drinking and urinating quite a lot.  Unfortunately the blood tests revealed that her calcium levels are above normal (7-12 is the normal range, apparently, and she had a reading of 13.6).  As she had anal sac adenocarcinoma almost two years ago (resulting in the surgical removal of the anal gland), the vet thinks it will almost certainly be related to the return of the cancer.  She describes it as paraneoplastic syndrome, and didn't advocate any further treatment... meaning we have to watch Luna deteriorate as her calcium levels rise and the cancer grows.

 

I can't stand the feeling that she's being "written off".  While we were only given three months as a prognosis when the initial tumour was discovered nearly two years ago, it's still come as such a shock.  We thought she'd beaten it.  Perhaps it is better not to know where it has spread to, but I feel we know nothing about what is going on with her.  Does she have a tumour in the other anal sac?  Could it be removed... and would or should we put her through that since it's a ghastly operation, and there is no guarantee that this very aggressive cancer hasn't spread into her spine, lungs or brain?  Chemo and radiotherapy are out - even if it was agreed to (the vet said it wasn't an option at this stage), we wouldn't but her through those.  Dialysis was mentioned as a way of getting her calcium levels down, but the vet hasn't had much success with that, and Luna is so petrified of going to the vet that I don't think spending 4 hours on a drip every few weeks would be fair.  We don't want her last weeks or months (if we are lucky) being purgatory for her.  There is another test that could be done to confirm the raised calcium is being caused by cancer, but the vet didn't feel there was much point.  I understand it involves taking more bloods using a special kit sent up from a lab in Birmingham, and then they have to be sent by courier down to Birmingham (within a certain time frame).  Then again, from what I've read, the other possible causes of hypercalcemia are parathyroid related or bone disease, neither of which have non-evasive treatments or good outcomes.

 

At the moment she is very happy - besides the excessive drinking and urinating, you wouldn't know there was anything wrong with her.  Some of the other symptoms of paraneoplastic syndrome and hypercalcemia make of very unpleasant reading (lack of appetite, vomiting, decreased gastrointestinal function, constipation, confusion, depression, bladder stones, anemia) but she has none of those.  Her appetite is very healthy indeed, she's positively delighted to get out on her walks in the stubble fields, and still enjoys a good game.  Perhaps that's in part down to the daily dose of Metacam she gets for her arthritis!  Also, the vet said that all of her other blood results were good, including her kidney function.  So at the moment her body is coping pretty well with the rise in calcium, and the Metacam.

 

I don't know what I am asking for, but if anyone has any advice, from homeopathic remedies that might help to support her, to ideas for reducing calcium, or anything else for that matter.  At the moment we aren't  even sure how excessive the 13.6 calcium reading is, or how quickly it might rise, or whether we should get Luna's bloods checked every few weeks. Nor do we know what we might do to reduce the risk of dehydration as this gets worse.  So all comments and advice are much appreciated. 

 

- Rebecca

 

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So sorry to read your news....my thoughts are with you tonight xxxx

So sorry to hear of your loss. They are such fighters aren't they...She's at peace now though. My thoughts are with you.

rest in peace Luna

So sorry to hear about Luna, she was a fighter. Take care

Joan and I send our sympathy and know how you are feeling.It is a year since we lost Fred.Words can't help but knowing that we care and that we are thinking of you might be of some comfort.

Love

Joan and Howard

Hi Rebecca, so sorry to hear about Luna, great name by the way, my thoughts are with you, they leave such a huge hole in our lives these dogs but what a brave girl she was xxxx 

So sorry for your loss of Luna Rebecca. She has left no doubt some big paw prints on your heart.
I hope our retriever we have has the years your Luna did, three monrhs ago our Shelby had the very same surgery. We will keep you In our thoughts Dianne and Irish. X

I am so sorry Rebecca ...

So sorry for the loss of your beautiful and brave girl ( x

Thank you so much for all of your kind words and thoughts.  It has meant a lot reading through them as they've come in over the last few days. 

I am a bit calmer today, and so I went out for the first time in the car, and took Murphy, our Irish boy, in the hope it would cheer him up.  We visited my mum, and Murphy explored the house and garden, and then we went on a walk that Murphy hadn't done before.  It brightened the day for both of us. 

Dianne, I hope your Shelby does well.  I did quite a bit of research at various points, and while I'm certainly not an expert, do get in touch if you ever need a sounding board or advice.x

Thank you Rebecca. I'm always keen to know anything that will help my Irish and our Shelby with their health especially when there not well. Shelby has to have a CT Scan at this stage every three months to see of recurrence, that will be at the end of October. One thing you mentioned and we agree with you, it's not a pleasant surgery at all!! Our Shelby was so fit at the time of diagnosis for a very active ten year old that it hit all of us so hard. There wasn't much choice....surgery or let the tumor take over and end her days fast. Glad we did, she bounced back and is annoying her Irish brothers/ sisters again. If there is anything you can guide us in or suggest as to help her, we would be so very grateful.
Take care Rebecca. Dianne, Irish & Shelby.

I can relate to this, Dianne.  When Luna's tumour was discovered when she was 9 years old it was only because we thought she was having trouble with an anal gland, but the vet felt the lump in the other gland, put her on antibiotics just in case it was an infected absess (unlikely, but we were trying to avoid surgery), but as it didn't clear up after 7 days we had to have the lump removed and sent away for pathology.  Horrible having to have surgery on a dog who didn't have any outward signs whatsoever of being ill.  She didn't understand, and it really depressed her, but like Shelby she did bounce back. 

There were a couple of things we changed for Luna post surgery.  One was her diet - we put her onto a home cooked diet with fresh meat, veg and potato/pasta/rice, which she adored.  She was crazy for vegetables... brussel sprouts and asparagus were her favourite... and this from a dog who was a fussy eater!  In retrospect I would probably have gone the raw feeding route (but with veg), but she liked her food so much and was thriving on it, so I didn't want to change. We were lucky as I could get venison and occasional rabbits from my brothers, but we also had heart, beef, chicken, turkey and a wee bit of liver from time to time.  The research I did into low protein diets and raised liver enzymes didn't hold true - it seems to be an old fashioned way of thinking... things have moved on - and although her diet was fairly high in protein, it wasn't a problem.  I think you already feed raw.. is that correct, Dianne?

I also started to give her Seraquin for her joints as she had arthritis, but also this is the only joint supplement that contains turmeric which has anti-inflamatory and anti-oxident properties - I was really keen to give her turmeric.  And she had raised liver enzymes, so she had Denes Milk Thistle+ Powder, and later Denamarin.  Oh, and peanut butter (a natural one with no additives from a health food shop).  She adored it, and had an open sandwich of peanut butter every day, which was handy for delivering her pills, and peanuts are of course full of vitamins and minerals - see http://www.peanut-institute.org/health-and-nutrition/protective-nut....  This was one of the last things she would eat when she became anorexic (peanut butter over venison!).  I have no idea what was so successful for her, but as I say, she thrived, right up until the week or so before we had to say goodbye.

Wishing Shelby the best for his scan at the end of the month.x

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