Part 3 (of I don't know how many) of Roo's last week

The last time Roo ever carried the hat.

The last time Roo ever carried the hat.

Doctors Mason and Philibert jointly misdiagnosed the end of Roo’s remission when they did the fine needle aspiration of the lump on her arm and opined that Roo had developed a second form of cancer. The lump was in fact extranodal swelling, the lymphoma, and once that lump appeared, it became ferocious. It’s awful to harbor the suspicion that had Mason and Philibert recognized it for what it was there might have been time for the rescue protocol to buy some more time. Maybe not. And maybe if Mason had recognized the lump in Roo’s back that I had pointed out weeks before it might have indicated the need to switch to other chemo drugs. Either way, now that the cancer was progressing viciously, Mason bowed out. Though she had assured me that she was as capable an oncologist as any, lacking only board certification, I credit her with admitting that Roo’s case required greater specialization than she was able to provide.

My friend Jim had warned me about oncologists. That maybe because they dealt so much with death they tended to a certain coldness. This was certainly true of Philibert. After Mason transferred Roo to him and I met him for the first time I told him that I didn’t want to discuss any of the grim stuff in front of Roo. I asked if we could talk about her treatment out of her earshot, maybe step out of the room. It would have been nothing to get a tech to wait with her in the examining room for five minutes.

“No,” he said. “Not unless you want to put her in your car.”

It was over 80 degrees in bright sunlight. I wasn’t going to bake Roo. Jim was right.

As Roo’s swelling and discomfort got worse in her last week, I emailed Philibert to ask about putting her back on the prednisone. The lumps in Roo’s throat were hardening. He said to do it. Maybe I should have known better. It might have been a mistake, a last ditch attempt to beat the swelling back, to restore Roo’s failing appetite, to make her feel a little better. It was an attempt not to let her sink underwater.

I felt like I was committing a crime when I put the little prednisone pills down Roo’s throat. She trusted me so much and she was so good at taking all those pills, but I knew these were going to make her feel bad. She was also tried of taking pills, grunting almost silently to let me know. Within hours the panting began. Now she had that on top of feeling ill and tired. Immediately it seemed like a mistake, another reminder that I might now be putting her through too much. Was I letting hope override not just my instinct but what I could clearly see? Roo was obviously declining. The cancer was through screwing around. 

Over the next day or two, though, the prednisone did seem to provide some comfort to Roo. She was weak but able to rest more. The panting would come and go. I was torn between hoping that it was just an effect of the prednisone and hoping that it wasn’t because of some pain or feelings of sickness from the cancer itself or the low dose daily chemo drug she was still on.

At dawn on Friday morning, an email appeared in my inbox suggesting that I look into a drug for Roo. I bolted up in bed and turned the tablet on and looked it up, even before I leaned over the bed to check on sleeping Roo. The over-the-counter deworming drug Panacur, which can be bought at any pet shop or feed store, had been demonstrated to have astonishing anti-cancer effects. Panacur is a 60-year-old drug manufactured by Merck. A few years ago, Merck was experimenting with the drugs in its catalogue on cancer. The Merck scientists realized that mice who had been given Panacur to prep them for a cancer study could not be given lymphoma, normally an easy thing to do. Research was done and published in the most prestigious science journal, Nature. It showed that the Panacur, whose drug name is fenbendazole, acted to destroy cancer cells in many ways without harming healthy cells. One of the Merck scientists happened to have late stage glioblastoma, an incurable brain tumor. With three months to live she decided to try the Panacur. Within weeks her tumor had disappeared.

Then a man named Joe Tippins, who had Stage IV metastasized small cell lung cancer was informed by a veterinarian acquaintance about the use of Panacur for cancer. At the time he was in an advanced cancer drug study at the M.D. Anderson cancer hospital in Houston and started taking the Panacur without telling his doctors because he knew he would be thrown out of the drug study if he was diluting the results with an addition to his protocol. In weeks Tippins’ cancer disappeared entirely and appears to have stayed away. As of this writing, he has had a dozen quarterly PET scans and still no evidence of disease. He was the only patient out of 1100 in the drug study to survive.

A woman posted a video of her shih tzu who had, she said, a lymphoma lump in her neck the size of an orange. Three weeks later the lump was gone and there was no evidence of disease. Recent facebook groups popped up and others reported successes.

The problem was that it took some time for the Panacur to work. Roo was too far gone. Still, I emailed Philibert to ask if there was any harm. He did not respond. Not knowing that I could buy the Panacur at the store myself I called Mason’s office to ask for some. Mason likewise didn’t bother to reply.

It was a sunny Friday and Roo was feeling good enough to come outside and lie in the driveway. When Virginia came out of the house to say hi – “Hello, Mrs. Rooboola Boobola!” – Roo wagged and smiled. She was in a good mood to begin with and always happy to see Virginia, who she loved. 

When I learned that I could get the Panacur at Petco, Virginia babysat Roo so that I wouldn’t have to leave her alone in the camper or drag her along for an uncomfortable ride in the car. Roo, as she always did when she waited there stayed by the front glass door of the house, watching and waiting for me. She watched me drive off and she was still there, her head and ears up, when I got back.

I had been hoping to hear back from the either one of the vets because Roo had been developing more gastrointestinal problems and I wanted to make sure the Panacur wouldn’t hurt. But neither of them could be bothered. They probably didn’t want to say that they thought the experiment was idiotic. The dose of Panacur given for cancer treatment is only one-quarter the amount given for deworming a dog Roo’s size. I sprinkled it on some of the rotisserie chicken I had been buying for Roo. She was still eating solid food and scarfed it down.

Now, the truth is that I am not an optimistic person. Maybe I was once, but it no longer comes naturally to me. It doesn’t generally seem realistic. I can’t help but see the way humans treat each other, treat the planet, treat animals. For every kind person there seem to be ten cruel ones. It looks to me like the country seems to be heading into a toilet. I can’t help but think that increasing political tension combined with advancing surveillance technologies is going to lead ineluctably to an eventual authoritarian state. And yet, as unreasonable as it was, giving Roo the Panacur gave me some hope.

In all the hours of talking to Roo while she was sick, I never lied to her and never would. I had been telling her that I knew she was sick. And that we were doing everything we could so that she would feel better.

Sometimes I would say, “Yes, Little Bear, I know you feel so sick now. But you’re going to feel better. Everybody gets sick. Your old daddy has been sick, too. Tomorrow you’re going to feel better.” Sometimes it was a good thing my face was buried in the fur at the back of her head so she couldn’t see the tears.

The protocol for the panacea is three days on and four days off. That meant that Roo would have to take it on Saturday and Sunday, too. For the rest of Friday, Roo spent some time lying in the driveway. I sat beside her in a camp chair. Occasionally we wandered briefly in the back yard. Once or twice she spotted a chipmunk and took a brief run at it.  When it got dark we went back in the camper. Any time Roo went to sleep I left her alone and watched her and listened to her snoring. It seemed worse and I worried that the lumps inner throat were impinging on her airway. Every time she woke up and looked back to see me I got down on the floor with her. Sometimes, when I shifted my position a little she got the idea that I was going to get up and tried to bat at me with her paw, but her arm was swollen and it was hard for her.

“Oh, Chigi Bear Beker, I’m not going anywhere,” I would tell her, and it would calm her down. We did this until three or so in the morning when I had to try to get some sleep.

On Saturday it occurred to me to call Dr. Stokes in Oklahoma. I’ve written about Dr. Stokes many times over the past few years. What qualifies him as one of the great veterinarians is that apart from having the science well in hand, he has an endless amount of care for the animals in his care. I left a message on his voicemail and in no time he called back.

Roo and I were in the camper and I went outside so she wouldn’t hear me when I filled him in on how Roo was doing. We hadn’t spoken since the day after Roo first came down with cancer in Tennessee. I told him she was still wagging, still smiling, still going out for a brief sniff in the yard.

“Well, that’s good. As long as she’s still having more good days than bad. That’s when you’ll know.”

We spoke for about a half an hour. He said there was nothing to lose by trying the Panacur. Even if there was no data to support its use and no protocol for its administration for cancer and just anecdotally encouraging evidence about its efficacy, he said there would be no harm. It would not make Roo feel worse. I don’t know if that’s the last time I’ll ever have occasion to speak to Dr. Stokes. I doubt that I’ll ever have occasion to talk to any more veterinarians, but talking to Stokes felt like leaving the field on a high note.

I know how foolish it was to place any hope at all in something like this. Even the staunchest proponents said that it took time to work. I knew Roo and I were out of ammo. This was a potshot at an advancing enemy who was much stronger and about to overrun the trench.

And even though it didn’t work, the little bit of hope it added over the weekend was a good thing. It made it easier for me to tell Roo to hang in there. Easier to tell her she would feel better tomorrow and that as soon as she felt better we were going to go and catch a ground hog and go swimming and frog hunting. We spent a lot of time on the floor talking about that stuff, me on my knees beside Roo and leaning down to place my head beside her on the tattered old dollar store rug.

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This is the story about Panacur for cancer. Worth reading, and the links to the peer reviewed studies are in there. Had I known about this sooner I would have been giving it to Roo. There are also facebook groups for it, but they are, frankly, awful, filled with people who can’t be bothered to read the instructions or who post all sorts of things sounding authoritative about the need to add numerous other things to the protocol. The Panacur protocol is extremely simple. It requires only the Panacur, some broad spectrum vitamin E and curcumin.