Status Quo

Life is in a stable place for Toby. After his checkup at the end of May, we knew Toby was having some issues with the at-home chemo treatment with Palladia. As happens with this drug, Toby is beginning to show signs of kidney malfunction.

Here begineth the Science lesson...

From our late May appointment in Scarborough:

While the bloodwork looked mostly within range for Toby there was one item that sent off warning bells: the elevated creatinine level of 2.6. That is above the high range for kidney function of 0.8 - 2.4 mg/dL  (milligrams per deciliter). From Wikipedia: "Creatinine... is a breakdown product of creatine phosphate from muscle and protein metabolism. It is released at a constant rate by the body (depending on muscle mass)." This is a normal process and healthy kidneys can remove it  from the blood and send it out of the body. If the kidneys become damaged and are restricted from removing it regularly, creatinine will build up in the body. By the time the creatinine levels are outside the high range, it is thought that at that point the kidneys have lost about 75% of their effectiveness.

At that May appointment it was recommended we would have his blood rechecked in a month with our local vet, which we did. Effectively, that test showed no real change:

Here endeth the Science lesson.

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So, it was decided with our oncologist in Scarborough that we would keep Toby on the Palladia for now. It will be month to month, with many, many blood tests and decisions regarding alternatives. Toby was diagnosed in late fall, 2024 and has beaten the odds with cancer while on Palladia (an average life expectancy of 123 days in a study group with only around a 50% response rate.) Toby has been on Palladia for about 210 days, and still going strong.

For now, Toby is healthy, considering what he is dealing with. He is stable and as normal can be. He's engaged and engaging with the world. Food and water are essential parts of his daily life and being with me is still his top priority. Finding places like our screened-in porch has become an essential part of his health regimen, even if it is sitting on the back of the couch, watching the world go by, or in Zen-like contemplation of  his cat-navel.

Perhaps he is happiest when he can pester me at my desk. That's when he plays the game, "Guess what's in the Cubby Hole"...