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April 25: Prednisolone May 4: Elspar
May 8: Weight Loss / Dehydration May 14 May 15: Recheck
May 16-17 May 18
After a 2-month fight with lymphoma, Bitsy passed away May 18, 2012. She will be greatly missed from the Happy Cavy herd. RIP Lady Bitsy.
THIS IS PART #4 IN A 5 PART SERIES:
PART 1: Bitsy And Guinea Pig Lymphoma
PART 2: Bitsy Goes for Radiation Treatment
PART 3: Bitsy’s Guinea Pig Radiation Therapy, Part II
PART 4: Bitsy’s Cancer Treatment: Prednisone & Elspar
PART 5: Bitsy Has Crossed The Rainbow Bridge
Another update on Lady Bitsy‘s fight against guinea pig lymphoma.
The Bad News: The tumors are still growing and new tumors have begun to show up. After two doses of radiation, the tumors are thus far radio-resistant at the levels Bitsy can reasonably tolerate. Therefore, radiation is no longer a treatment option.
The Good News: The cancer is very slow growing, which gives Bitsy a good chance of living a full, happy life while the Humans explore other cancer treatment options.
Read along for updates on Bitsy’s progress and her fight against guinea pig lymphoma.
Phone Consultation and Prednisolone Order
April 25, 2012 – Cost of Care: $20.40 (plus $3 for shipping)
What Was Done: Order first round of prednisolone
After consulting with the HappyCavy family doctor and Bitsy’s oncologist, conventional multi-drug therapy is Bitsy’s lone alternative.
Currently, Bitsy is taking a once-daily dose of prednisolone (Prednisone) at 0.36 mL every 24 hours. Prednisone is a cortico-steroid (anti-inflammatory drug) which reduces swelling in various parts of the body. It will be used in conjunction with a dose of L-asparaginase (Elspar), which will be administered tomorrow at the family doctor’s office.
The side-effects Bitsy could experience during her course of prednisolone treatment include:
- Increased thirst
- Increased appetite
- Increased urination
Tomorrow, Bitsy has an appointment with the good doctor to receive an injection of L-asparaginase. Using Elspar is a promising treatment option as it was suggested that using Elspar can reduce the size of Bitsy’s tumors, decrease the rate of tumor growth, and even possibly send the cancer into remission. We will update this post with details on tomorrow’s appointment.
Since receiving prednisolone treatments, Bitsy has regained some of her energy and playful personality. She no longer falls asleep near the hay rack and has been seen playing with her sisters, a good sign that she is starting to feel better.
L-asparaginase Injection
May 4, 2012 – Cost of Care: $110.00
What Was Done: Intra-muscular injection of L-asparaginase (Elspar) chemo therapy
Bitsy received a dose of L-asparaginase (Elspar) with the hopes that the drug could slow the tumor growth or lead to temporary remission of the cancer. The good doctor said that if Elspar works well for Bitsy, it could take up to 10 days to see tumor shrinkage.
The HappyCavy Humans are continuing to give her prednisolone. The possible side-effects of taking Elspar — gut upset, blood in urine, fatigue, lethargy — could take up to 5 days to manifest.
Re-Check, Possible Dehydration
May 8, 2012 – Cost of Care: $46.70
What Was Done: Brief exam and subcutaneous fluids
On the afternoon of Monday, May 7, the Humans began to notice excessive urination and drastic weight changes. Already very under-weight at around 33.2 ounces, Bitsy dropped an incredible 5 ounces under 48 hours, even though she appeared to be eating and drinking normally.
Despite hand-syringe feeding of water by the Humans, Bitsy continued to drop weight even into Tuesday afternoon. The Humans knew quick action had to be taken, so they scheduled a follow-up appointment with the family vet to see what was going on.
The HappyCavy vet commented on the large size of her tumors. He recommended that the Humans cut her prednisolone dosage in half to 0.18 mL every 24 hours. The vet also confirmed that Bitsy was very dehydrated and promptly got the permission of the Humans to inject up to 150 mL of subcutaneous fluids.
The vet also suspected that Bitsy had a mild gut upset, so he prescribed Reglan at 0.41 mL and acidolphilus every 12 hours as needed until her gut returned to normal.
With an engorged upper back filled with fluids, Bitsy returned to the HappyCavy Humans tired and very weak.
During the next week, Bitsy’s strength continued to decrease but her weight remained stable at 29.5 ounces. On Thursday, May 10, Bitsy begna having trouble moving, and, the next day was completely immobile. The Humans began administering hand-feedings of Critical Care and water to maintain her weight and hopefully help bring back her strength.
More Updates
Bitsy continues to remain immobile and hasn’t moved from one spot for quite some time. The Humans have been making every effort to keep her engaged, fed, and hydrated. Her mood still seems happy and she enjoys eating. This gives the Humans hope as it is apparent she is not suffering.
So far, no visible side-effects from Elspar. It is unclear whether Bitsy’s immobility is caused from the Elspar or Prednisolone or tumor load.
After consulting with the family vet, the Humans increased Bitsy’s prednisolone dosage back to 0.36 mL every 24 hours. Through online research, Human #2 learned that patients who receive Prednisolone can experience adverse side-effects if dosages are reduced suddenly. The vet agreed that it would not harm Bitsy to increase her prednisolone dosage back 0.36 mL, so the Humans began doing so immediately.
Re-Check
May 15, 2012 – Cost of Care: $39.40
What Was Done: Brief exam
Today Bitsy is happier and has been eating under her own power. She is also able to move around a bit more, even if it is with much difficulty.
In the afternoon, as Bitsy sat smiling and munching on hay, the Humans noticed what appeared to be an injured left shoulder. This made them think, “Perhaps this has lead to Bitsy’s immobility?”
Off to the vet! The good doctor was concerned with Bitsy’s progress: her immobility, muscle wasting, and tumor size. He confirmed that her should seemed injured and most likely torn ligaments: nothing could be done but just to make her comfortable and continue hand-feeding and hand-hydrating if needed.
Since the doctor was concerned about Bitsy’s muscle wasting, he suggested she receive unlimited pellets and orchard grass which both offer high protein which will help her retain muscle and possibly help her regain mobility. Due to her atonic bladder and concerns about calcium in her diet, Bitsy had been receiving limited pellets and oat hay. The switch was done immediately, and, while she wasn’t very fond of the orchard grass, she continued to receive Critical Care which had a high protein content of 16%.
Bitsy continued to receive unlimited pellets, orchard grass, Critical Care, and hand feeding of water. Despite the Humans’ best efforts, Bitsy’s decline in health continued rapidly.
The Humans began to have to contemplate the most uncomfortable thoughts that a guinea pig care-taker ever has to face: euthanasia, a time to let go and let Lady Bitsy run free in dandelion fields across the Rainbow Bridge. If Bitsy continued declining in health, the Humans were preparing to arrange for their goodbyes on Saturday, May 19.
Bitsy Has Crossed The Rainbow Bridge
MAY 18:
Today, Bitsy has crossed the Rainbow Bridge.
Humans #2 woke up at 9 AM and noticed that Bitsy wasn’t eating and was very cold. Her belly had turned blue and there was little doubt: Bitsy was very close to crossing the Rainbow Bridge.
After waking Human #1, it was immediately decided: It’s time to end her struggle. She had put up a strong fight and the Humans needed to make a decision that could give Bitsy a restful passing. The Humans made Bitsy comfortable, Human #1 called the vet, and in the car they drove off.
Human #2 held Bitsy during the entire drive, petting her head and singing songs. “Bitsy,” said Human #2, “It’s OK to let go. You’ve fight hard, little one, and it’s finally your time to decide what’s best.”
After arriving at the vet, the Humans were rushed into an exam room. The doctor arrived just as Bitsy breathed her last breath, shortly after 10 AM.
Bitsy’s struggle ended peacefully and without pain, leaving just enough time for the Humans to say “goodbye”.
The Humans opted to have a necropsy performed on Bitsy to determine the nature and extend of her disease. Bitsy was a unique case in that she received radiation, so it would be beneficial to the doctors and possibly the guinea pig community as a whole to find out what might have helped, what didn’t help, and what really caused poor Bitsy so much trouble.
Furthermore, several of the most damaged organs will be sent to a pathologist who can provide the Humans an even better idea of what and why things happened the way they did.
The necropsy and pathology results will be posted in a separate entry.
Thank you to everyone who has provided love, compassion, and encouragement during Bitsy’s ordeal. We have the BEST Facebook, Twitter, Flickr, and Blog friends a guinea pig family could ask for!
Rest in peace, Beautiful Bitsy. You are loved and sorely missed.
hope she feels better!!!!!
I am so sorry to hear that Bitsy did not make it through all of this. She was clearly a very strong willed guinea pig and fought back to the end. I am waiting to hear back from my vet as to whether or not my guinea pig has lymphoma. To be prepared I wanted to read others stories and experiences with different treatments. Cost is also a concern. This was the most helpful story and cost assessment I could have possibly stumbled across. Just know that the most important part is that you are giving all of your piggies (including Bitsy) the life they deserve: a happy life full of love. In the end that is all that matters.
Thank you so much for your kind words! I’m happy that you found Bitsy’s story useful. Good luck to you and your piggy!
this is making me cry
🙁
Every time I read this, it makes me cry. I have to hold my guinea pig, Nugget every time! Bitsy left a legacy that will shine on forever. therefore, I send love from My guinea pig to yours! God bless you Hammy, Feebee, Buttercup, And Dot.
Thank you, Marita. It’s true – us fuzzies don’t stick around long enough; squeeze us tight and give us kissies and don’t take it for granted! Blessings to you and Nugget as well. Thank you for your friendship 😀