Primary Veterinarian Check-Up

Margarita’s had her first “post chemo” check-up with Dr. Campbell, our primary veterinarian on July 24, 2019.  Dr. Campbell listened to Margarita’s heart with a stethoscope.  Those of you who have been following along know that she had a grade 3 murmur at the end of her chemo treatments.  However, today it was classified as a grade 2!

Margarita has been on a daily regimen of 10mg of Pimobendan, Salmon oil, 1 packet of Fortiflora, 2 CAS Options tablets, 30mg Coenzyme Q10, 3,000mg Taurine, 2,000mg L-Carnetine.

Margarita has been cleared to spend more time outside, run at her own will in the yard, take some longer leisurely walks, and to swim more regularly! We are overwhelmed with happiness and gratitude today! She will see Dr. Campbell again in 3 weeks, and her cardiologist again in 4 months.

16 Months into the DCM Diagnosis

It has been 16 months since Limoncello was diagnosed with DCM, and 11 months since she has been on a kibble that includes an appropriate source of protein, goods grains, and is free of legumes. As scheduled at her last check-up with Dr. Bossbaly, Limoncello had a cardiology exam and echocardiogram on July 23, 2019.

As Limoncello was getting her echocardiogram, I waited in Dr. Bossbaly’s exam room praying she would return with news that Cello’s DCM had not worsened. When Dr. Bossbaly entered the room with a big smile, exclaiming, “YAY!” I was completely caught off guard, and confused! My nervous response was, “What do you mean?… Her DCM stayed the same and didn’t worsen…RIGHT?” What came out of Dr. Bossbaly’s mouth next made my own heart skip a beat… “Limoncello’s heart has completely corrected itself from DCM,” she said. “NO WAY!?” Was all I could manage to get out before I burst into tears of joy.

Dr. Bossbaly explained that Limoncello’s heart was back to normal both in size AND function. Cello did still have a murmur, but it downgraded from a 3 out of 6 to a 2 out of 6. Dr. Bossbaly lifted all exercise restrictions, and approved of Limoncello coming out of her dock diving retirement to compete again! After speaking with our primary veterinarian, Dr. Campbell, she agreed as well. HALLELUJAH!

We understand that we have been blessed with the fact that Limoncello’s heart has healed to the point of normal size and function. Unfortunately, not many dogs have been this lucky. Limoncello is a prime example of a dog diagnosed with DCM directly related to Taurine deficiency. We are beyond grateful that Limoncello made a complete turnaround with the implementation of a dietary change and proper supportive supplements.

Many people have asked us what food we suggest they switch their dogs to in order to get their pups off of a grain-free diet. Our suggestion is the same for everyone. All dogs are unique – and all dogs have different nutritional needs, just like humans. Take into consideration your dog’s health issues, daily activities, do some research on dog food companies, and consult the doctors you trust the most before making a decision on food. Keep in mind that not all dogs do well on all foods. It may take a bit of experimenting before you settle on appropriate food and supplement choices for your pup.

K9 Fun Zone 3rd Annual Wild Card Double Header; Caledonia, Ontario, Canada

We’ve had a rough start to the season between Porter’s seizures and Margarita’s Lymphoma and complications that followed.  We weren’t even sure we were able to attend this event until the morning we were supposed to be leaving for our road trip.  In fact, it wasn’t until about noon on July 3rd that I finished up with Margarita’s last oncology appointment and got the “ok” from her oncologist, Dr. Risbon, to travel to Canada with her.  We didn’t preregister for the competition, knowing we may not even be able to attend.  A lot of the jumps were marked as “full” but we know that each venue usually holds about 5 slots for people to sign up on the spot.  With all of this in mind, we set still out on our way to Canada late in the afternoon of July 3rd.  Boy, are we glad we did!

 

Limoncello

Limoncello enjoyed being a part of The B.A.A.A.R.K Foundation charity ball drop and having a girls GLAMping weekend with Margarita lounging in the air-conditioned camper.

Hooch

Hooch had the second longest jump of the competition! This was also his first time competing in a national event as an Iron Dog. His performance should earn him an automatic World Championship invite in Elite Division Big Air, Nitro Division Speed Retrieve, and Gladiator Division Iron Dog!!

Big Air:

23’7″                      1st Place Elite Division

23’9″                      1st Place Elite Division

Big Air PRO Finals:                     

22’0″

Pic Credit: Nancy Miller

Extreme Vertical:

6’2″

Speed Retrieve:

6.564 seconds         1st Place Nitro Division

Iron Dog:

2973.62 points       1st Place Gladiator Division

Lager

Lager had an absolute blast this weekend getting to play his favorite game of Dueling Dogs, and participating in The B.A.A.A.R.K Foundation charity ball drop! His performance this weekend should land him an automatic World Championship invite in Turbo Division Speed Retrieve and Titan Division Iron Dog.

Big Air:

19’11”

20’5″                              3rd Place Masters Division

19’2″

20’4″                              1st Place Masters Division

Extreme Vertical:

5’10”

Speed Retrieve:

7.304 seconds                1st Place Turbo Division

Iron Dog:

2876.3 points                   3rd Place Titan Division

Dueling Dogs:

Lager made it to the first round of finals, but unfortunately was bumped out in the last round.  He LOVES this game!

Margarita

What a weekend this little Diva had…Margarita enjoyed Donuts, a banana split, a convertible ride, a Canada Goose stuffed toy, and other gifts from our Canadian DockDogs family!

Whiskey

Wish-The-Fish came out in FULL force and she increased her jumping distance with each leap into the pool, earning a 2nd or 3rd Place medal for every jump and a new PB of 8’3”! We are hopeful her average Big Air score will earn her a World Champion invitation in the Novice Division, but we will have to wait and see if the Invite Fairy pays her a visit!

Big Air:

3’5″           2nd Place Novice Division

7’5″           3rd Place Novice Division

8’3″           2nd Place Novice Division

7’0″           2nd Place Novice Division

Porter

Po-Po had a great time walking the facility grounds and also enjoyed an amazing massage from Marti at Pawz Therapy !

Liver Killer Bling:

River Forest Park: Weedsport, NY

We did a quick over-night stay at River Forest Park in Weedsport, NY on our way up to Canada for the 3rd Annual K9 Fun Zone Wild Card Double Header.

Whiskey checked out the Seneca River before we departed.

W.I.N.

Week 15 Recap and Oncology Visit #16

“You can’t get back what you’ve lost.

What’s Important Now is what it is that you still have.”  ~Jimbei

Week 15 Recap

As of last week, Margarita is officially done her CHOP chemotherapy treatments.  Unlike many other unfortunate dogs, Margarita made it completely through her entire round of chemo,  and we’re taking that as a WIN.  However, as with many other warriors, she did not end this battle without acquiring some battle wounds. Some of this damage is temporary…Margarita’s hair on her face and belly should begin to grow back, and the dark pigment on her nose and muzzle should eventually fade to reveal her signature pink-piggy-nose …But a cardiology evaluation revealed a devastating battle wound that will scar her permanently.

July 1, 2019

After a heart murmur was discovered during Margarita’s Emergency Room visit, we scheduled a Cardiologist appointment with Dr. Bossbaly at VSEC.  Dr. Bossbaly is the cardiologist Limoncello sees as well.  During that appointment, we received some shattering news.  Margarita, like our Limoncello, was diagnosed with Dilated Cardiomyopathy.  However,  Margarita’s case is much more severe.  She also has a grade 3 heart murmur (the blood is not flowing properly through her heart, particularly the mitral and tricuspid valves) as well as a significant cardiac arrhythmia (irregular heartbeat in the form of ventricular premature contractions).

So what does this all mean for our Sweet Reet? Below is the information conveyed to us by Dr. Bossbaly:

Dilated cardiomyopathy (DCM)  is a disease where the heart muscle becomes a weak and has difficulty pumping blood out of the heart throughout the body. Because of this weakening, the heart chambers become enlarged, one or more heart valves may leak, and signs of congestive heart failure (fluid in the lungs) may develop. The cause of dilated cardiomyopathy is not known; however, given the prevalence of this disease in certain breeds there is a suspected genetic basis for this condition. Occasionally, DCM-like heart muscle dysfunction develops secondary to identifiable causes such as toxins or an infection. More recently, it has also been thought to be connected to grain-free diets due to the fact that legumes in grain-free kibble block the body’s taurine absorption.  In Margarita’s case, it is believed the DCM is caused by the toxic effects of the chemotherapy drug, Adriamycin.

Early in the disease process there may be no clinical signs detectable, which is why this was not discovered in Margarita earlier. As the disease progresses, a heart murmur or other abnormal heart sounds and or irregular heart rhythm can be detected upon physical examination, as when the ER doctor heard Margarita’s murmur during her ER visit. The presence of heart muscle may weaken and her ventricular arrhythmias may result in weakness or lethargy, exercise intolerance, or fainting episodes for Margarita. I am finding this hard to type, but Margarita is also at risk for sudden death. As the heart’s pumping ability worsens, the heart enlarges and pressure builds up within the heart. When the heart is unable to compensate for the disease further, fluid may accumulate in the lungs, in the chest cavity, or in the abdomen. These are signs of congestive heart failure. The presence of fluid in these areas can cause difficulty breathing or coughing, so we will have to monitor Margarita for those symptoms.

The prognosis with dilated cardiomyopathy is guarded. Despite medical therapy, this disease will continue to progress with further weakening of the heart muscle. Margarita is at risk of developing congestive heart failure and is unfortunately at risk for worsening of the ventricular arrhythmias. Periodic echocardiograms and a halter monitor (if warranted) will help keep an eye out for disease progression and can dictate changes in medications which can help Margarita continue to have a good quality of life. Often, with the discontinuation of the chemotherapy, the heart may partially recover.

Dr. Bossbaly placed Margarita on a daily dose of Pimobendan. This is a medication used in Dobermans with dilated cardiomyopathy. This medication improves the strength and efficiency of the heart and dilates blood vessels to promote blood-flow out to the body. Side effects are very rare, although it is possible that Margarita could have some G.I. upset.  It is not known if Pimobendan helps with toxicity-induced cases of DCM, however Margarita’s heart is significantly enlarged and the contractility is severely compromised, so we are hopeful that this medication will help our Sweet Reet’s heart get strong again. Margarita also has major activity restrictions. She is not allowed to run freely, and should not be put in any situation where she is upset.

Like Limoncello, Margarita’s sleeping respiratory rate (SSR) will have to be monitored on a daily basis for the rest of her life. The sleeping respiratory rate is a subtle indicator of changes in Margarita’s condition; increasing trend may suggest the development of congestive heart failure. Normal sleeping respiratory rate should be less than 30 breaths a minute, so we will be tracking her SSR along with Cello’s using the app, Cardalis. Unfortunately, this app only allows for tracking one patient, so we have to chart the results ourselves. We will be in search for another app that allows for easier tracking of multiple patients, if possible, and welcome any recommendations our family, friends, and followers may have. Increases in respiratory rate and effort while sleeping will be reported to both Rita’s primary veterinarian (Dr. Campbell) as well as her cardiologist (Dr. Bossbaly) immediately.

Margarita will return to VSEC to be re-evaluated by Dr. Bossbaly in 4 months, and will also have an exam scheduled with     our primary veterinarian, Dr. Campbell, in approximately two weeks.

We wholeheartedly do not regret our decision to get chemotherapy for Margarita, as it did help her WIN this round against Lymphoma.  Had we not chosen that path, Lymphoma would have taken Margarita from us months ago, as Lymphoma patients generally only survive 1-3 months when left untreated.  Considering the rough life Margarita unfortunately was forced to live prior to us knowing her, we were confident that she deserved a second chance at living a (longer) happy life. All that being said, the news of Rita’s severe cardiac disease on the last week of her chemotherapy plan sure felt like a punch in the gut.

We understand that just because Margarita is done with chemo doesn’t mean she is done with Lymphoma, as 90% of dogs with this disease will relapse.  We are remaining optimistic about her cardiac issue and focusing on being grateful for the WIN that others have not been so fortunate to celebrate – the WIN of our little warrior taking a big bite out of Lymphoma, and making it to the end of her chemotherapy treatments.  As we celebrate that WIN, however, we will also focus on the W.I.N. This “end” is really just the beginning of a new chapter.  What’s Important Now is that we remain positive and help Margarita become healthy and strong so that she can combat her heart disease. What’s Important Now is celebrating each and every day that we are blessed to still have her in our lives.

We will also start planning some of those escapades on that Adventure List of hers!

This Week’s Treatment

Week 16:  The Final Week of the CHOP Protocol

Hey, Lymphoma…Guess What …You LOSE!

No chemo this week (YAY!), as Margarita completed all of the CHOP treatment plan.  Instead of chemotherapy drugs, Margarita had an abdominal ultrasound, blood test, and physical exam.  I also had the opportunity to sit down with Dr. Risbon and discuss the plan for long-term monitoring.

Abdominal Ultrasound

No abnormalities were found during Rita’s ultrasound.

Blood work

Margarita’s white blood cell count was a bit low, so she was placed on an antibiotic as a preventative.

Physical Exam

Rita’s physical exam was good.  Her mammary gland still feels like there is abnormal tissue present, so this will have to be closely monitored.

Discussion with Dr. Risbon

Dr. Risbon explained that Margarita is a special case, which is very concerning.  Lymphoma usually resurfaces in 90% of patients in the same manor it did before chemo.  However, now that Rita’s spleen is removed, it is not known how or where the Lymphoma will show itself. We will have to be very observant, and vigilant in regular check-ups at Rita’s veterinarian as well as Rita’s oncologist.  She will be seen once a month by the oncologist for the next year, and more frequently by her primary veterinarian.  Even with Rita’s current heart issue, there are treatment options if relapse occurs, if she is deemed healthy enough at the time to receive those treatments.

Dr. Risbon said that preventative medications (flea/tick/heart worm) are fine to continue, but it is recommended to hold off on vaccinations in order to reduce unnecessary stimulation of the immune system.

This Week’s Treat

WINner WINner, chicken dinner! After Rita’s WIN in her first battle with Lymphoma, she sampled the Big Chicken Deluxe sandwich (minus the lettuce and tomato) at Checkers !

I will continue to post updates with any visits to the veterinarian, cardiologist, or oncologist.

As always, thank you for joining Margarita in her journey to take a bite out Lymphoma.