Chemo Round 5 For Max

Chemo Round 5 For Max. Max's GME Update. This is an update of the chemotherapy protocol of our dog, Max who is battling Granulomatous meningoencephalomyelitis (GME). This is a canine disease where the white blood cells attack the central nervous system.


This is an update of the chemotherapy protocol of our dog, Max, who is battling Granulomatous meningoencephalomyelitis (GME). This is a canine disease where the white blood cells attack the central nervous system.

Chemo Round 5 For Max

To recap:

In July of 2014 Max, our (now) nine year old Coton de Tulear was diagnosed with GME. I’ve written about his progress extensively, here and here and here and here and here. This is the original post where I detailed the trail to diagnoses and remission.

In January I relayed the sad news that our pooch, Max, had relapsed on his GME. We went to Cornell for the first of four planned chemotherapy treatments to try and push his Granulomatous meningoencephalomyelitis back into remission. I did not do an update post on chemo round three (although I probably should have). He’s already had five chemo rounds and a sixth-round is planned for later this month (so much for 4 rounds!).

Above is a photo of Mr. Max in his stroller. His stamina isn’t that great, so we have been taking him for walks in his stroller. He either starts the walk (see photo below) or ends the walk on his paws, but for much of it he gets pushed around by us.

Chemo Round 5 For Max. Max's GME Update. This is an update of the chemotherapy protocol of our dog, Max who is battling Granulomatous meningoencephalomyelitis (GME). This is a canine disease where the white blood cells attack the central nervous system.


He does continue with PT twice per week where he does the water treadmill for 20 minutes, although at a lower incline these days. He also does agility over some bars. He continues to get massage therapy 2-3 times per month.

Last month I recounted all the meds Mr, Max is currently on. It is a lot. A real lot.

This month the update is all about his gallbladder.

We have noticed that GME-wise Max showed a marked improvement from April to May. And, it is continuing into June. He still circles to the right all the time. Habit? Learned behavior? Brain lesion? no one knows, but it is safe to say it is GME related and it probably isn’t going to abate.

Each time Max has gone to Cornell this year, in addition to the round of chemo, he is also getting a sonogram. They want to measure the size of his liver, kidneys, and gallbladder. They also take a blood test panel to see how his “numbers” are doing.

After each sonogram, we have received word that his gallbladder had grown. It has stretched. It was called “fried”. (Sounded weird to us too.) And this is concerning as Max is not really a candidate for surgery.

Since he is immuno-suppressed healing would be tricky, assuming he survived the surgery. Hubby is now into homeopathic supplements to try and aid Max’s liver and gallbladder (in addition to the pharmacy medications he receives). I am fine with it as none are contraindicated, and at this point what do we have to lose? Max needs that gallbladder to get smaller. It doesn’t have a plug, but it could rupture due to how thin it is stretched. Trying to slow or stop (and hopefully reverse) the stretching, may be Mr. Max’s best chance for survival.

I did make the comment to Dr. Laura Scoda (who has has been seeing recently at Cornell): “So it isn’t the GME that is going to get him, it is his gallbladder?” and she responded in the affirmative. Poor little guy.

His Pred was cut back a tad when we left this time. We cut back again this Friday. Steroids can do marvelous things, and be evil at the same time. Max’s steroid use has suppressed his white blood cells the past (nearly) 4 years. But, the same steroid use has also taken a toll on some of his organs. By reducing his Prednisone to first .4 ml, and then .3 ml, it is hoped that it will help the gallbladder. It certainly has helped returned his appetite to “fussy eater” status!

We head back in a few weeks for round 5 of Max’s chemo. If he makes it to the 4th of July, it will be 4 years he’s had GME. He was diagnosed with GME on July 10, 2014.

I mention this because the prognosis is not-leaving-the-hospital to 3 years. Mr. Max is well past that now. His neurologist at Cornell told us months ago that Mr. Max is the longest living diagnosed GME patient they currently have. Every single day with him is a gift – even the days when he is being a PITA.


Previous Max posts (read in order from the bottom up to follow his whole story):

Chemo Round 4 For Max
Chemo Round 2 For Max
Max is Back to Chemo for His GME
Max Had a Relapse
Mr. Max April 2016 Update
Max March 2016 Update
Mr. Max Post Cornell Visit Information
Max’s Latest GME Update
Max’s GME Update, One Year Later
Max’s GME Update, Month 11
Max’s GME Update
An Update on Mr Max, March 2015
Updating Max’s GME
An Update On Mr. Max
Last 2014 Trip To Cornell For Max
Back To Cornell
Max’s First Cornell Follow-up Visit
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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Chemo Round 4 For Max

Chemo Round 4 For Max. Max's GME Update. This is an update of the chemotherapy protocol of our dog, Max who is battling Granulomatous meningoencephalomyelitis (GME). This is a canine disease where the white blood cells attack the central nervous system.


This is an update of the chemotherapy protocol of our dog, Max, who is battling Granulomatous meningoencephalomyelitis (GME). This is a canine disease where the white blood cells attack the central nervous system.

Chemo Round 4 For Max

To recap:

In July of 2014 Max, our (now) nine year old Coton de Tulear was diagnosed with GME. I’ve written about his progress extensively, here and here and here and here and here. This is the original post where I detailed the trail to diagnoses and remission.

In January I relayed the sad news that our pooch, Max, had relapsed on his GME. We went to Cornell for the first of four planned chemotherapy treatments to try and push his Granulomatous meningoencephalomyelitis back into remission. I did not do an update post on chemo round three (although I probably should have).

The last month has been a bit of a rough ride for Mr. Max. In March, he was put on several new medications in an oral form. He’s a terrible pill-taker, and we wanted to make certain he gets all the meds he needs. Since he is a small dog it is fairly easy for me to lift him up on my lap, tap his teeth, and inject his meds.

Currently he is on:

• Prednisone (.5 ml)
• CycloSPORINE (1 ml – .5 2x daily)

Those are specifically to fight the GME symptoms.

Since we began chemo in January, Max has also had a sonogram each time to check the size of his liver, gallbladder, and pancreas. They are also checking for stones. An infection of the liver/gallbladder was also suspected. They are enlarged, and it could be for one of two reasons – infection or steroids. To be safe, they prescribed new medications. For this area he is taking:

• Amantadine (1.5ml)
• Ursodiol (1.5ml, 2x daily)
• Metronidazole (1.3 ml, 2x daily – more on this below)
• Enrofloxacin (.5ml)
• Sam-e (.1 ml, 2x daily)
• Milk Thistle (.8 ml)
• Pregabalin (15 mg, 2x daily)
• LiverAid (3x daily)

This past week was the first time they labeled Max has having gallbladder disease. They are watching for a mucus plug to make sure his gallbladder does not rupture.

Max had several episodes of collapsed back legs in mid-April so we took an emergency trip to Cornell. While there, it happened again. We had videoed his weakened left leg (ataxia), but the ability for them to see the collapse was “helpful”.

Hubby discovered that the Metronidazole can cross the blood-brain-barrier and lead to the weak back leg problem. The neurologists are unconvinced, but within 24 hours of pulling him off the Metronidazole, his legs stopped collapsing.

Unfortunately, his blood test numbers for his gallbladder came back elevated, and they had us put him back on the Metronidazole on the 21st. We are watching it closely as this in conjunction with the Enrofloxacin are to combat his (presumed) infection. They want to pull him off the Enrofloxacin when the infection clears, but are open to pulling him off the Metronidazole instead (first) if the leg issue arises again.

Max is a terrible pill taker. Simply awful. As his Pred is dialed back, he reverts back to his fussy-eater persona. That means getting pills in him becomes even more difficult. This isn’t like your regular pooch that will eat anything – Max is more cat-like in his eating habits.

Sooooo that meant the denamarin he needed to clear up his liver was not always getting into him. Denamarin is an over the counter medication. Hubby found the main components in liquid form, and asked is we could give those instead of the pill. We were given the go on that, and the Milk Thistle and Sam-e in liquid form replace that pill (and his liver numbers are very close to normal now!)

As I mentioned in my last Max post Mr. Max is in uncharted territory. He’s survived many months past the original prognosis of three years. Giving him chemo again to get him back into remission is not well documented – dogs living this long with GME are just is not common.

So, instead of four rounds spaced four weeks apart and then lenthening the interval between the fourth annd fifth round, we are heading back for a fifth round of chemo in four weeks again. His first time through the chemo he was lengthened to five weeks, then six through 18 months. It appears the idea is to be more aggressive this time. I have no idea if it will work. Honestly, I am not positive that the neurologists at Cornell know if it will work. But, as his original neurologist said nearly four years ago when I asked if we were torturing him, “you are giving him a chance”. And we will continue to give him a chance.

Max is a tough little guy. As long as he is not in pain and can have a reasonable quality of life, we will continue with his treatment. Our concern is the steroids doing him in or his immune-suppression allowing an infection to kill him. Right now, he wants to play, interact with us, and enjoy life.


Previous Max posts (read in order from the bottom up to follow his whole story):

Chemo Round 2 For Max
Max is Back to Chemo for His GME
Max Had a Relapse
Mr. Max April 2016 Update
Max March 2016 Update
Mr. Max Post Cornell Visit Information
Max’s Latest GME Update
Max’s GME Update, One Year Later
Max’s GME Update, Month 11
Max’s GME Update
An Update on Mr Max, March 2015
Updating Max’s GME
An Update On Mr. Max
Last 2014 Trip To Cornell For Max
Back To Cornell
Max’s First Cornell Follow-up Visit
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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Chemo Round 2 For Max

Chemo Round 2 For Max. Max's GME Update. This is an update of the chemotherapy protocol of our dog, Max who is battling Granulomatous meningoencephalomyelitis (GME). This is a canine disease where the white blood cells attack the central nervous system.


This is an update of the chemotherapy protocol of our dog, Max, who is battling Granulomatous meningoencephalomyelitis (GME). This is a canine disease where the white blood cells attack the central nervous system

Chemo Round 2 For Max

In July of 2014 Max, our (now) nine year old Coton de Tulear was diagnosed with GME. I’ve written about his progress extensively, here and here and here and here and here. This is the original post where I detailed the trail to diagnoses and remission.

Last month, I relayed the sad news that our pooch, Max, had relapsed on his GME. We went to Cornell for the first of four planned chemotherapy treatments to try and push his Granulomatous meningoencephalomyelitis back into remission.

So many things have changed for Mr. Max:

His circling decreased and got wider. The small, tight circles of January were not as prevalent – only a few times this past month were they small and tight. Less circling is a good thing!

A few days before he was to have his chemo treatment, we went to our local vet and had his panel done. The blood test showed elevated white blood cells, and a decrease in his liver numbers (a good thing). He was put on denamarin in January after his liver enzymes came back elevated – a result of the huge Prednisone dose he has been taking for the last two months. This happened before, so we again hoped the denamarin would work… and it did.

When we got to Cornell they ran new bloodwork. His white blood cells had returned to normal range, so his neurologist thinks they were elevated was because he was feeling poorly last week.

However, on doing his physical testing she noticed the area around his stomach was showing pain. They did an ultrasound for his gallbladder. His gallbladder is enlarged, but there is no sign of mucus blockage or sediment. Because of this, we did get another medication – ursodiol – to try and make his gallbladder happy (so the plug doesn’t happen and so sediment doesn’t form a stone).

In January we were concerned because Max had lost weight while on a high dose of Prednisone – this month we are concerned because he gained almost TWO pounds!! For a small dog (15#) that is a huge weight gain. Because of this, and the discomfort surrounding his abdomen, Hubby was pushing for a decrease in the Prednisone. He wanted to go from 7.5mg to 5mg. Originally, Dr. Stephan agreed to that, but then she changed her mind and just dropped him to 6.25mg. I asked if it was because she was not convinced he was yet in remission, and she responded in the affirmative.

Chemo Round 2 For Max. Max's GME Update. This is an update of the chemotherapy protocol of our dog, Max who is battling Granulomatous meningoencephalomyelitis (GME). This is a canine disease where the white blood cells attack the central nervous system.


Hubby and I sat down with Dr. Stephan to talk about Max’s future. The three-year longevity span came and went last July. As I said last month, we were (nicely) reminded that Max is well past that point. So, I asked how many dogs were past the three-year mark: she knew of FIVE (Max is one of them!). It was actually four now as one of those five pooches developed diabetes due to the high Pred, and was put to sleep.

Of the four dogs with GME currently being treated at Cornell that have survived longer than three years, Max is the one with the longest survival. By that I mean he was diagnosed the longest ago and is at the 3 years (nearly) 8-month mark – none of the other dogs are that far over the 3-year mark.

One of the questions I asked was about a necropsy. Like Alzheimer’s in humans, GME can only be 100% completely diagnosed in dogs after death. All the symptoms are there, the MRI says THIS, but the diagnosis confirmation happens after the pet has died. Since this may not happen on a visit to Cornell, I wanted to be certain Max could help future pets with this horrible disease (his local vet can arrange it). He’s clearly a fighter, and obviously, his treatment has been superior for his survival. If other pets (and their owners) can benefit from Max’s diagnosis and treatment, we want that to happen.

While Max may continue to beat all the odds and again enter remission for his GME, we are at the point where we know it is just a matter of time. Every day with him is a gift we will cherish. It is amazing to me how a little 13-pound dog (his natural weight before all this happened) could be so tough. The little guy is a real fighter.


Previous Max posts (read in order from the bottom up to follow his whole story):

Max is Back to Chemo for His GME
Max Had a Relapse
Mr. Max April 2016 Update
Max March 2016 Update
Mr. Max Post Cornell Visit Information
Max’s Latest GME Update
Max’s GME Update, One Year Later
Max’s GME Update, Month 11
Max’s GME Update
An Update on Mr Max, March 2015
Updating Max’s GME
An Update On Mr. Max
Last 2014 Trip To Cornell For Max
Back To Cornell
Max’s First Cornell Follow-up Visit
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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Ann's Entitled Life Ann's Entitled Life Ann's Entitled Life Ann's Entitled Life Ann's Entitled Life Ann's Entitled Life Ann's Entitled Life
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