Been debating how to do a Max update, while its really bad news, there is a bit of light. Max is still fighting and still with us. He's improved since we got home from the cruise as far as energy and such. But, we did have the advanced ultrasound scan done Friday (was amazingly clear and detailed).
It was a very long day on Friday, traffic in and out of Philly sucked big weenies. We left at 1:15 and got home right before 8 pm.
We are accepting and facing the reality that we can't save Max. Its a miracle he's alive today, he's had 4 surgeries and now on chemo, on so many levels he's a miracle and truly a first in avian medicine across a few pages. We know he won't be with us forever, but how long is up to him, he's overall strong right now and healthy in alot of ways, but the cancer will claim him, not today or tomorrow, but one day before his time should come. Could be 5 weeks, 5 months or if we're blessed a couple years, there is absolutely no other parrot on medical record to compare his case to.... he's already defied most odds and expectations, so literally its just be thankful for everyday he's still here being the Big Blue Brat.
But, what we learned and the plan.... sadly, both lobes of the cancer are still there, about the same size, so positive to focus on, the cancer is not larger nor has it spread.
Liver and kidneys look great, heart looked fine, so good there. The cyst sac has regrown around the mass, but oddly, its keeping the fluid contained so the fluid is not damaging his organs, so oddly, that might buy us more time, because his organs are not being compressed by the fluid that his body is producing. I joke its like the old spill the beans game, the fluid builds up in the sac around the tumor, then the tipping point it drains straight down to his lower abdomen for very easy drain using a butterfly needles like used for infusions. Very thin, and Victoria can add that to her lists of first aide for critters! She's a pro at draining him at home when needed between vet visits.
Dr Tyson suggested we stopping the fungal meds, at this point she agrees that the stress on his kidneys and liver are not worth it. We want to support overall body health to keep him as strong as possible, the less stress on his body and organs, the better for him at this point. And Max appreciates 3 less doses of meds being shoved down his throat!
We are adding some palliative care meds... he got a first lupron injection Friday, another hormone like the implants, but monthly injection that is a bit more potent, Doc is hoping they will have a more direct impact on the tumor behavior and fluid. And we are switching to an injectable inflammation med hoping it helps reduce fluid/inflammation better than the oral med (and again, easier on Max. Onsior will be about a weekly injection that we will likely do at home (Tor have him the first one yesterday).
And i was happy that Doc agreed with me wanting to do chemo every 2 weeks. He does great for about 10 days or so after chemo, then the fluid increases like 5 times as much. So she's 100% onboard that we bump up chemo if I feel it will keep him more comfortable. I know, crazy right!?! Whoever think you'd hear someone say chemo improves overall comfort and quality of life but parrots tolerate chemo weirdly well, but we all knew what few cases we had to research, while its tolerated well, its just not as effective as seen in mammals. So while the chemo is not killing the cancer, it does seem to keep it in check, so long as Max is tolerating the treatment, it will be part of the course of palliative care.
So, hoping these changes will keep him happy and much more comfortable for however long they work and as long as he is happy, active and not giving up, we will keep up with the care plan. Max does not really hide not feeling well, its very obvious when hes having a bad day. And we do know there will be a few bad days, such as the 36-48 hours after the cyclophosphamide dosing, hes a very tired boy,quieter than usual and we need to supplement his calories more on those days, but then he perks up and gets sassy and more his blue brat self. So long as we see mostly good days, I'm okay needing to spend the bad days giving him extra care.
So,that's the full and bluntly honest Max update. We don't know when we will need to say goodbye, but we've been discussing plans for when that time comes. But for today, it was extra attention and encouragement to eat more, lots of head rubs and a long nap in his heated troll cave that he still loves!
Some recent pics of Max including drunk Max after his scan Friday.
