Clinical spine
The Timeline
This timeline is the clinical spine of Oscar's story. It is not a treatment protocol. Soft gaps are marked where primary records still need attachment.
| Date / phase | Event | What happened | Why it mattered |
|---|---|---|---|
| April 3, 2025 | Diagnosis | Ultrasound: solitary heterogeneous irregular mass along caudal dorsal bladder wall into trigone and proximal urethra (± distal left ureter); ~3.2 cm × 1.3 cm; marked left renal pyelectasia (~1 cm) with dilated left ureter; prostate symmetrically enlarged (~6.27 cm width). | Location created urinary obstruction risk — more than generic bladder cancer. |
| April 3, 2025 | Prognosis | “Maybe six months” with chemo. | Became the number the method worked from. |
| April 2025 | BRAF+ | BRAF mutation test positive prior to oncology consult. | Supported urothelial/TCC diagnosis and early planning questions. |
| April 2025 | Early planning + GI monitoring | Records gathered; symptoms tracked. Piroxicam started mid-April with food; held late April for GI, then restarted with daily omeprazole cover. | Built the monitoring loop — including early holds when stool/GI signals changed. |
| May 1, 2025 | First IV chemo | One IV dose of mitoxantrone while waiting for DNA results. | Started treatment before molecular map returned. |
| May 5–12, 2025 | Molecular profiling | Vidium SearchLight DNA (Accession SL25-000232; received 05/05/25; reported 05/12/25): site trigonal urethral; urothelial carcinoma; BRCA1 CN loss, PDGFRA CN gain, NF1 p.Ser1045fs, TSC2 CN loss; ABCB1-1Δ not detected. | Created mutation-to-treatment question map (not prescriptions). |
| May 22 – July 2025 | Carboplatin + olaparib | Switched to carboplatin + olaparib May 22, 2025 after DNA results; multiple carboplatin treatments under my oncologist (including at least 5/22, 6/11, 7/3, 7/24). | Preceded strong bladder/trigone/urethra site response. |
| July 3, 2025 | Bladder-site response | My oncologist: “Strong partial to complete response of urinary tumor today; unable to clearly visualize any cancer on trigone or urethra.” Radiology summary: mildly progressive pulmonary metastatic disease but almost complete resolution of bladder tumor. Pulmonary nodules still present. | Site response at bladder/trigone/urethra — not whole-body remission; lungs still had disease. |
| August 2025 | Oral control | After lung lesions had been slightly larger, carboplatin was discontinued and Palladia/toceranib was added under my oncologist; Oscar continued on Palladia + olaparib at home. | Shift to oral RTK control while keeping PARP logic; reassessment of lung nodules planned ~3 weeks after starting Palladia. |
| Aug 27, 2025 | Lab signal | Platelets dropped; Palladia held pending recheck. | Monitoring loop prevented blind continuation. |
| Sep 4, 2025 | Thoracic radiographs | Board-certified veterinary radiologist read, compared to 7/24/25: stable pulmonary metastatic disease. Nodules similar in number to prior study, measuring up to ~2.7 cm; several with a small air-filled/cavitary center (radiologist: may represent focal necrosis). Study ~3 weeks after starting Palladia to reassess lung nodules. | Confirmed stable mets — meaningful extra time; lung disease not racing ahead. |
| Sep 2025 onward | Long middle | Oscar remained himself: beach, ocean swims, walks, meals. | Time bought by treatment became real life. |
| May 2026 | Progression | Perianal lesion, hind-end weakness, cloudy urine, restlessness. | Disease changed location and comfort burden. |
| May 2026 | Cytology | Perianal lesion confirmed metastatic urothelial/TCC. | Ended “maybe abscess” uncertainty. |
| May 13–14, 2026 | UA/UPC | Turbid urine; protein 3+; blood 3+; WBC >50/hpf; UPC 2.3 (interpret with sediment). | Marked urinary inflammation; monitoring concern before trametinib. |
| Mid-May 2026 | Final targeted phase | Trametinib started (NF1/MAPK logic); Palladia stopped/held; olaparib context continued. Sirolimus was prescribed/discussed in May 2026 but never started. | Last major targeted oral attempt. Exact first trametinib swallow date remains a soft gap. |
| Late May–June 2026 | Comfort focus | Resting comfort improved early; movement pain worsened; QOL thresholds central. | Shift from control to comfort. |
| June 16, 2026 | End of life | Oscar was euthanized. | 439 days after diagnosis. |
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