Max’s First Cornell Follow-up Visit

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Max's First Cornell Follow-up Visit


Max, our nearly-six-years-old Coton de Tulear was diagnosed with GME last month. I’ve written about his progress extensively, here and here and here. This is the original post where I detailed the trail to diagnoses and recovery.

Mr. Max, Hubby and I returned to Cornell last week so Max could have a follow-up visit with the neurologist at Cornell, as well as another chemo treatment. During this visit, he is hooked up to a drip for a 24 cytosar treatment. This is his chemotherapy agent. His hair is thinning – a lot – but the spots where he was shaved in anticipation of back surgery (that never happened) have begun to grow in. His back legs look like someone chewed on them. They are missing a lot of hair as they were shaved a few times for iv insertion.

Max's First Cornell Follow-up Visit


Note: Max does have hair (just like you and me), not fur.

Dr. Slanina, his neurologist at Cornell, was very pleased with his progress. She initially indicated that she wanted to decrease his Prednisone, but when she saw the results of his blood tests, his white blood cell count were high, so she abandoned that idea (for now). Eventually she hopes the white blood cell count stabilizes and then Prednisone will be reduced.

He’s on a bazillion meds (or 6) at this point. When we went in to pick Max up at discharge, we have a consult with the 4th year student (who is there to observe) and Dr. Slanina. When his current 4th year told us about the increase in pills, and we groaned, she started to laugh (involuntarily). We asked her if she pilled him, and she admitted she had – with help! She stated he was “not an easy one to pill”.

As I have stated before: Max is a horrible pill taker. At home we can now hide the pills in food and treats (the steroids make him hungry, so instead of being non-food-motivated, he’s now motivated to eat treats!), but the liquids have to be shot into his mouth with a syringe. Good times! I hold Max while Hubby tried to shoot into his open mouth. Fortunately, Max screams bloody-murder when you try and shoot that liquid into his mouth. I say fortunately, because even though he’s a moving target, he has to open his mouth to scream. That’s when Hubby hits the plunger to shoot the meds into his mouth.

Max is not allow to have NSAIDs. He’s on steroids and you can’t mix non-steroid meds (like RIMADYL) with a steroid. That means his world of pain relievers is quite small. Because he still has back problems, and the neurologist felt he was in significant pain, his pain med was switched from Gabapentin to ‎Pregabalin, and his dosage increased. He now takes the ‎Pregabalin twice a day, and WOW do we notice a difference! For one, he sleeps through the night. As in we wake up first!! This is awesome and a long way from when he first came home in July and got up every two hours. He sleeps on his side with his four paws outstretched. This indicates he is very relaxed and pain-free.

He is still in rehab, and it was suggested we start acupuncture for him again. I discussed this with Max’s rehab vet and she felt he would benefit from acupuncture too. We shall see where that goes.

We return to Cornell in four weeks time for another round of chemo for the pooch, and the round after that is also scheduled for four weeks after that next four-week-out-session. After those next two rounds, Dr. Slanina hopes to push him to five weeks, then six weeks. I am not sure what the spacing is from there. She has already given us the name of a vet neurological practice in Florida (which is about 30 minutes from our condo!!), and we have made the decision that our return home in March or April will include a stop at Cornell for Max.

So, lots of updates, a few changes, the end result being that Max is doing very well. He has regained 99% of the weight he lost. He’s sleeping, more “Max-like” and also more “dog-like”. Some of the personality changes may be here to stay: food motivated, he’s lost his fear of heights (poop), he is sleeping better, his bark is deeper, and his coordination is better. We continue rehab, may add in acupuncture, and continue to medicate him several times per day.


Previous Max posts:

Max Exercises More Than I Do!
Updating the Mr. Max Situation
A Mr. Max Update
Mr. Max, Mr. Max, Mr. Max
It’s A Mr. Max Post!



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Comments

  1. Oh thanks be to God this is great news! I am still praying for your baby and love to hear of his progress. I too had to medicate my cat with liquid pain meds shot into his mouth and if you think it is fun with Max, just imagine doing it to a snarling cat! I had to pin his head down and shoot it in when he started screaming with the other hand, but as anything in life that is difficult, you two will get better with it in time. I am so happy to read he is more comfortable and improving. Please tell him he is still handsome even if his hair is thinning. He is a gorgeous dog indeed, even sick, still so cute! You and Coupon Stud are doing a great job with providing him with the best care possible. My mother had acupuncture for her dog and it did help. She also found a chiropractor who could adjust her dog as well and that helped him a lot as well. I am still praying and will continue to pray for your Max.

    • Debb, if you think of that snarling cat’s mouth-shot of liquid, that is Max. I pin him down in my arms, and if I don’t get his arms tucked in just right, all bets are off. Fortunately, the second liquid ended last night and we are back to one.

      Hmmm a doggie chiropractor. Hubby mentioned that a while ago, and I’m not sure he ever looked into it. I will remind him.

      Thanks Debb!!
      Ann

  2. I am so glad he is doing well. He is so lucky to have you two as owners.

  3. Hi,
    I found your website when researching GME. My Maltese Doc was just diagnosed yesterday. He is my baby, abd a few of my other Malts are related to him through the bloodline. I am concerned for them also. I am so happy your baby is doing well! What vet did you see in Florida? I live in Saint Augustine (I saw you winter here). I feel you are giving Max gold standard care and I want Doc to have the best. My neurology vets did not mention chemo, just prednisone, anti siezure and an immunosupression drug. I really want Doc to survive.

    • Hi Michelle, I am so sorry to hear about your baby. In small dogs, it is called the Maltese/Pug disease, so unfortunately, not unheard of. The Coton de Tulear is a “cousin”, so Max got “lucky”. To read his journey, this is my last post. All the links to the GME story are at the bottom of that post… start at the bottom.

      Who are your neurology vets? We went to North Florida Neurology. That is where Max went for treatment when we were in St. Augustine this winter. They did two two chemo shots (not a drip), one shot two days in a row. Since your pet was just diagnosed, they may suggest a MRI to be certain it really is GME – if you have not had one done yet, DO IT! According to the neurologists at Cornell, that is the only way to be 99% sure it is GME (like Alzheimer’s they can’t know for sure until after death).

      I wish you the best on this Michelle. Please do not hesitate to contact me and let me know how your Doc is doing.

      Ann

  4. Hi Ann,
    Thank you for you quick reply! We went to North Florida also! Doc had an MRI and a spinal tap. It is on very early stages of GME, localized in one area. It is thankfully not NE or the more severe ones. Though GME is very serious.
    I was wondering if I should go to Gainesville (University of Fl) or a Speciaist that I read about in Boston or Cornell (we are New Yorkers originally). I have read so much about chemo…my next question will be why Doc is not on this.
    Thank you for your information and support.
    I will keep you updated. I am sending prayers for Max and will keep up to date on his progress! Thank you!

    • I would absolutely ask them why Doc was not put on chemo. (Max has cytosar drips at Cornell and locally. He had injections at NF Neurology.) Max now takes (9 months later) 1/4 Prednisone tablet (.125 I “think”) because while Prednisone does some great things, long term we could see a lot of negative effects. He will be on Cyclosporine forever (or so we were told last week).

      Once you have your answer from NF Neurology, then you can make your decision on Gainesville. And if you don’t like those answers, head up to Cornell. The only problem I can see with a second or third opinion, is NF Neurology taking offense (although they are doctors, so I honestly can’t see that happening). At on hour away, you are going to want to use them for treatments as it is pretty close, although University of Florida is only 90 minutes away.

      Ann

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