Those of you who have been following along for a while know that Margarita was diagnosed with Stage 4 Lymphoma in 2019, and is officially a survivor. Throughout Margarita’s Lymphoma Journey, she periodically had elevated liver values. Through the guidance of her medical team, we were able to get these levels under control by adjusting her prednisone dosage. As a part of Margarita’s oncology check-ups, our primary veterinarian, Dr. Campbell at Old York Veterinary Hospital, suggested that we continue with regularly scheduled bloodwork to keep an eye on those liver values. More recently, those levels skyrocketed and Rita also had lost weight. Margarita’s prednisone dose was increased and an earlier-than-usual re-check of her bloodwork was scheduled. Despite an increase in both her prednisone dose and daily food intake, she continued to lose weight, her liver values more than doubled, and she just didn’t look or seem herself. She also began to display some incontinence – which we assumed was from the increased prednisone.  

Margarita also gets routine abdominal ultrasounds as a part of her Lymphoma check-ups. Although her last ultrasound showed a few small nodules on her liver, the findings were consistent with age-related liver appearance and thought to be unremarkable.  Margarita was not due for another ultrasound, but with the recent observations and blood test results, Dr. Campbell advised us to do a an early re-check. 

On June 3, 2021 Margarita had an abdominal ultrasound at Blue Pearl Pet Hospital. During this procedure Margarita’s radiologist, Dr. MacLeod, discovered that one of the small nodules on her liver suddenly developed into mass that was 3 cm in diameter. Dr. MacLeod also saw that Rita’s bile looked thicker than normal. A non-invasive needle biopsy of the liver mass was taken, as was a needle aspirate of her bile and her urine. 

On Friday, June 4 we spoke to Margarita’s internal medicine specialist, Dr. Peter Chapman, as well as her Primary veterinarian, Dr. Campbell. 

• During the initial cytology report, the cells of the liver mass were observed to be consistent with those of well differentiated carcinoma. This is not lymphoma- nor is it related in any way. In fact, there is absolutely no evidence of lymphoma. Brian and I are not yet uncertain if we will send this sample out to pathology for further testing, as Margarita’s other symptoms are consistent with what was noted in the cytology report.
• The bile sample showed significant bacteria in Rita’s gallbladder, so the sample is being sent out for further testing in order to give a better direction on what type of antibiotic would be beneficial to treat the infection- we should know the results by sometime this coming week
• There was no evidence of bacteria or white cells in her urine sample. We know that frequent urination and incontinence is common with higher doses of prednisone, but we did have this sample sent out for further testing to confirm to ensure Rita is not also dealing with a urinary tract infection- we should know the results by sometime this coming week as well

The hepatocellular carcinoma discovered in the liver biopsy does not respond well to chemotherapy. Additionally, due to the liver’s function, this type of cancer is also very rarely primary (in other words, cancer cells are most likely in multiple areas at this point). In a perfect world, the prime choice would be to remove the mass on Margarita’s liver and also remove her gallbladder. So which path do we take on this new journey?   As much of a gut-punch this new diagnosis is after Margarita surviving stage 4 Lymphoma, we also have to set aside our immediate desire to fix these issues and instead do what’s best for Margarita.  In addition to chronic hepatitis and intestinal disease, Rita also now has significant Dilated Cardiomyopathy (induced by her prior chemotherapy). There is a high possibility that she would not survive the surgeries needed. After a long discussion with our primary veterinarian who we trust wholeheartedly as Rita’s advocate, we have decided it is in Margarita’s best interest to forgo any type of invasive surgeries, and instead “treat the treatable.” Many of you who have travelled a similar journey with a fur-kid and have been faced with this same situation yourselves, know this was an EXTREMELY difficult decision. We are not giving up on her by any means. We will wait for the results of the bile and urine cultures and treat any findings as best we can with medication. Margarita will also have regular abdominal ultrasounds to keep a close eye on changes in the current mass on her liver and/or any new questionable developments. 

I definitely was not ready for this news and immediately was overcome by a rush of disbelief, anger, sadness and fear. I truly believe that positivity is powerful, so although managing the above emotions is not an easy task, I will be certain to shift my focus to gratitude to ensure Rita is in the best atmosphere possible. I cannot forget that in March of 2019, as Margarita began her chemotherapy to treat her lymphoma, we were told that she may not survive even a couple of months due to her significant liver and intestinal diseases. Instead, Margarita kicked (stage 4!!) Lymphoma’s butt and is a SURVIVOR. I am thankful to have been blessed with over 2 additional years with her that I thought I wouldn’t have.  Margarita has beaten the odds before, and I will remain hopeful that she will once again somehow find a way to take a bite out of cancer.  At the same time, Brian and I will respect Margarita’s wishes when this amazing warrior “tells” us she is tired of fighting her battles. Until then, I will enjoy and be thankful for each and every additional minute I am blessed to spend with this 4-legged angel. 

I hope that you will join me in walking beside Señorita Margarita on this difficult path, and continue to send positive thoughts and healing prayers throughout her journey. As always, thank you ALL for your love and support for Sweet Reet.