On Wednesday, August 7, 2013, Cloud was presented for a recheck of his lymphoma and second dose of chemotherapy. The following is a summary of his visit:
Medical Condition / History:
Ms. C reports that Cloud has been doing well since he received his first dose of lomustine chemotherapy on July 18th. The enlarged lymph nodes decreased in size rapidly and have not increased in size since that time. Cloud has been active and has a normal to increased appetite. Ms. C reports that Cloud shakes his head often but there has been no change since he was first diagnosed with aural polyps. Current medications: Prednisolone 5 mg q24h
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Diagnoses:
Large cell lymphoma – strong partial response to lomustine chemotherapy
Suspect otitis (ear infection), left ear
Historical aural polyps, bilateral
Treatment in Hospital: Convenia 52 mg SQ
Tentative Treatment Protocol:
Lomustine #1 (17 mg) – completed 7/18/13
Lomustine #2 (17 mg) – due 8/08/13
Recheck CBC – due 8/15/13
Lomustine #3 – due 08/29/13
SUMMARY:
Cloud looked good on examination today with a stable body weight. His lymph nodes have decreased drastically in size and are almost normal. The abdominal mass is still palpable but is much smaller that it was. This indicates a strong partial response to the lomustine. We rechecked a CBC today and Cloud’s blood cell counts were within the normal ranges so I have phoned in a refill of the lomustine to BCP Vet Pharmacy. Please phone the BCP to arrange billing and pick-up of this medication and administer the lomustine either tomorrow (8/8/13) or Friday (8/9/13). Cloud will need to have a CBC rechecked 7-10 days after he receives the lomustine to ensure that his white blood cell count does not drop too low.
I am concerned that Cloud may have an ear infection in his left ear today as there was some dried blood at the entrance of his ear canal. He did not tolerate cytology of the ear but we did repeat the antibiotic injection since both the lomustine and prednisolone are likely suppressing his immune system.
As previous, please keep a close eye on Cloud over the next couple of weeks for any potential chemotherapy side effects and contact NHVS if he develops lethargy, a poor appetite, vomiting, diarrhea, enlarged lymph nodes or any other abnormalities.
So to sum it all up, besides his ear infection, Cloud is doing really well. I have high hopes in the out come in his treatment.