With Hope, the Odds Don’t Matter: 18 Months in Remission

18 months ago Rita was diagnosed with stage 4 sub-stage A Large B-cell Lymphoma. If left untreated, she was given 1-2 months to live.

In March 2019, Rita began the CHOP-based chemo protocol. With her intestinal and liver diseases, it was uncertain she could even make it through her chemo plan. Her oncologist said with this treatment Rita would survive 12-18 months.

Despite the fact that her other health issues gave her a lesser chance than most, Rita made it through her chemo, and also reached every remission milestone that research said she most likely wouldn’t: 6 months, 12 months, and today…18 months!

We hold on to the faith and hope that she will not only continue to beat the odds and join the small percentage of dogs with Stage IVa Lymphoma who live 2 years, but that she also will defy “the norm” of her cancer prognosis even further!

Smiles for Miles: 16 Months in Remission

“A smile will go the mile, while a frown will take you down.” ~ Anthony Liccione

This July we have smiles …literally for miles… 32.68 to be exact! Once we got the go-ahead from Margarita’s medical team a few months back, I have been slowly increasing her activity level while continually checking in with the doctors to make sure Margarita is exercising at a safe level. Margarita now walks on any good-weather / safe-temperature days. Some of these miles also involved participation in 5K events that benefit different non-profit organizations to help others in need. I don’t focus on recording a fast time on our walks – in fact – I make it a point to let Margarita set the pace, and to let her enjoy every second of the walk, sniffing whatever she pleases. We take water breaks, take selfies, and most of all, take our time – something I am grateful to still have with this angel. Our walks have already created some pretty amazing adventures…and yes, I truly smile every mile! I am looking forward to logging more miles and memories with Rita in August!

Cardiology Check Up

Margarita saw her cardiologist, Dr. Bossbaly, at VSEC on July 29th for her scheduled echocardiogram and bloodwork recheck for her chemotherapy-induced Dilated Cardiomyopathy. Dr. Bossbally reported that she was able to detect a 2/6 whispy band shaped holosystolic murmur at the left apex. This is a great improvement from her original diagnosis. Margarita’s heart rate was 118 BPM and regular. Her lungs are also still clear, and she is breathing normally.

Margarita’s bloodwork did show some elevated liver enzyme levels once again, as she has had in the past.

Overall, Dr. Bossbaly said that Margarita’s heart disease is stable on her current medications, and added that there was no arrhythmia recorded during the entire echocardiogram. Dr. Bossbaly wants us to continue Margarita’s heart medication. She would also like us to continue tracking Margarita’s sleep respiratory rate (SRR). This is extremely important in anticipating fluid shifts and onset of congestive heart failure. Dr. Bossbaly added that she would like Margarita to be on her cardiac medication for the rest of her life in order to maintain her progress. Margarita will have another cardiology re-check in 6 to 8 months.

Monthly Check-Up with Primary Veterinarian

Margarita’s primary veterinarian, Dr. Campbell, at Old York Veterinary Hospital also examined Rita on July 29th. She was pleased with Margarita’s overall health and her cardiology report. Dr. Campbell also did a full exam, and checked Rita’s mammary tumors, which have had no significant changes. Margarita does not have any signs of a Lymphoma recurrence at this time. However, Dr. Campbell was not happy with the elevated liver enzymes, and would like to re-test Rita’s levels in 3 months.

Adventure List

Margarita also checked-off another adventure list item and enjoyed a picnic with her 2-legged cousin, James! Click HERE to see the full picnic post.

This Month’s Treat

Margarita enjoyed Classic Bantam Bagels from Starbucks!

Run for the Dogs 5K

Run for the Dogs was hosted by RunSignup .

During this 5K, our miles were completed (earlier this week before the heat wave hit) at Island Beach State Park in Berkeley Township / Ocean County, NJ… one of the few remaining undeveloped barrier beaches on the north Atlantic coast. It’s one of my favorite places in NJ!

Margarita also loves it here as there are many birds for her to point, and one of the only places where she will go in the water on her own!

For this 5K, a donation was made and split evenly among the following organizations:

The Earth has music for those who listen.
A dose of vitamin sea does the body good!

15 Months in Remission Recap

Margarita has been feeling great and has been very active this month! She even participated in two virtual 5K races: Best Friends 5K and part 1 of The Dog Days of Summer 5k Series !

Abdominal Ultrasound

It was time for Margarita to have an abdominal ultrasound re-check. Margarita may have these periodically due to her Lymphoma originating in her spleen. This was the first visit back to VSEC since Covid, so I was not able to go inside with Margarita.

Ultrasound Findings:
  • Liver: mild generalized hyperechoic enlargement (consistent with steroid hepatopathy), two small (4-5mm) hypo echo with nodules identified in the left medial lube. ( The doctor was not concerned with these). The previously noted 1-2cm nodule seen in December 2019 is no longer present.
  • Bladder: Non-dependent gas bubble noted in the bladder lumen
    • Due to the gas being consistent with Emphysematous cystitis, an ultrasound-guided cystocentesis was done in order to obtain a sterile sample of the bladder. The sample came back showing signs of E. coli. Margarita treated with enrofloxacin for this.

There were no abnormalities found in her gallbladder and biliary Tree, kidneys, adrenal glands, stomach, Intestines, colon, pancreas, peritoneum, mesentery, and lymph nodes!

Post-Abdominal Ultrasound Treat

Starbucks Chicken Double Smoked Bacon Panini!

14 Months in Remission Recap

May’s update is short and sweet!

Monthly Wellness Check with Primary Veterinarian

Margarita’s mammary mass has been changing increasing and decreasing in size, and also producing a clear discharge. This has been watched closely both daily by me, and monthly at her primary veterinarian and oncology visits. Due to the continued changes, our primary veterinarian, Dr. Campbell wanted to check Rita’s estrogen levels. An estrogen level blood test would indicate if perhaps during her spay, something was missed, causing her to have partial cycles. On May 4th we received the results. Rita’s estrogen level was 64.3, which is within the normal range for a female with no cycling. Although this provided a sigh of relief, it also does not provide an answer to why that mammary mass is acting the way it is. We do not want to put Margarita through any other stressful procedures, so we will be monitoring the mass and its changes along with continued communication with Dr. Campbell. Rita had blood work done as well. Dr. Campbell reported that the results showed that Margarita’s liver values continue to improve.

Monthly Activities

This month Rita continued to increase her activity and has been more vibrant than ever!

Agility

Rita enjoyed the homemade Agility course in our yard:

5K Races

Coronavirus Relief 5k

Those of you that have known Rita from the start know that she used to run 5k races prior to her Lymphoma diagnosis. For the first time since her diagnosis, Margarita completed a 5k! Rita participated in the Coronavirus Relief virtual race hosted by Virtual Strides . We walked this 5k, but it was just as fun as all the others we’ve completed together!

Run of the Pets

Margarita participated in “Run of the Pets” which was hosted by Virtual Strides .



A portion of the entry fee was donated to Best Friends Animal Society. The mission of Best Friends Animal Society is to bring about a time when there are No More Homeless Pets. They do this by helping end the killing in America’s animal shelters through building community programs and partnerships all across the nation. 

Monthly Treat

This month we had to once again skip our monthly-treat dues to Covid-19. Although some restaurants are now offering take-out, Brian and I have decided to not do anything outside our home to be extra safe.

13 Months In Remission Recap

Margarita has been doing wonderfully, and added another month of remission to her journey!

This month during the Covid-19 Quarantine, Margarita has been increasing her activity level to help boost her immune system and further increase her quality of life. We have also made sure her schedule allows time for relaxing activities out on the lake.

Rita loves agility!
Enjoying a canoe ride
Margarita loves taking in all the smells and scenery on her canoe rides.
Enjoying the warm sun and soft grass!
Enjoying a relaxing day out on the dock
Rita goes on a daily walk

Easter 2020

Easter… the only time of of the year when it’s perfectly safe to put all of your eggs in one basket. ~Margarita

Monthly Oncology Check-Up

Rita’s monthly check up with her oncologist, Dr. Baez, at C.A.RE.S has been postponed to May due to the Covid-19 outbreak. Both Dr. Baez and Dr. Campbell, our veterinarian, agreed this would be safe and appropriate since Margarita is showing no clinical signs of Lymphoma.

Monthly Veterinarian Check-Up

Margarita saw Dr. Campbell at Old York Veterinary Hospital for her monthly check-up. Dr. Campbell was thrilled with Rita’s progress. Rita’s mammary masses were reported to have little-to-no changes. Margarita’s heart murmur also sounded to have no change. Her liver values were re-checked through blood work, and all of her values continue to improve! Margarita will stay on her current regimen of medications and supplements:

  • Pimobendan for her heart disease caused by the chemotherapy
  • Prednisone for her liver disease (hepatitis)
  • CAS Options – an antioxidant and immune support supplement
  • Denamarin to support her liver

Monthly Treat

Our monthly treats and/or activities outside of our home will resume once it is deemed safe by the CDC to lift the Covid-19 stay-at-home-quarantine.

reMISSION Accomplished: 1 Year in Remission

First and foremost I hope that everyone is staying healthy during this uncertain time with the Covid-19 outbreak. All schools in the state of New Jersey have been shut down at this point and I am teaching remotely from home. Due to the statewide quarantine measures that are in place, I did not take Margarita to any special stores or restaurants to celebrate this day. Once it is deemed safe to do so, I definitely plan to make it up to her!

1 Year in Remission

Margarita reached a major milestone: Officially a SURVIVOR at 1 Year in Remission as of March 19, 2020!

When Margarita began chemotherapy one year ago today, the oncologist told us that without treatment, Lymphoma patients such as Rita usually have a survival time of less than 2 months. The doctor also told us that with chemotherapy treatment, the survival times for patients with Margarita’s type and stage of Lymphoma is 1 year to 18 months, with many patients not surviving the 16 weeks of chemo. I am overjoyed and overwhelmed with tears at the same time as I type this post. Margarita’s bravery, strength, resilience, and demeanor through her Journey has been extremely inspirational and astounding. She is a SURVIVOR!

Remission

What does “remission” really mean? In Rita’s case, it means that tests, physical exams, and scans show there is no evidence of cancer. However, this does not mean she’s cured. What it does mean is that the chemotherapy knocked down the cancer cells to a level undetectable by tests or microscopes. Margarita’s next milestone will be in October 2020 (the 18-Month Mark). I would be lying if I said I wasn’t worried about recurrence, and the unknowns that lie ahead. However, I am choosing to focus on Rita’s accomplishments and the positive choices and mindset that helped carry her through the last year with hope-filled days. Moving forward I will do my best to have optimistic thoughts only – there’s no time to waste worrying about the things I cannot control… so onward we go on this Journey together.

Lessons from Lymphoma

  1. Rita is a SURVIVOR – there are far too many who weren’t fortunate enough to celebrate this – so CELEBRATE!
    • In my opinion, one year ago today when Margarita was fully diagnosed, she became a cancer survivor. She conquered each day with such grace.
    • Each day with her is a gift, so I made sure to do fun, meaningful, and memorable things with her such as her Adventure List. I made sure we celebrated in some way each and every day so that I didn’t remain focussed on the past, or on the disease itself, as I knew my negativity would effect Margarita.
    • Don’t be afraid to share your pup’s Journey – and your feelings about their story! Cancer is a part their history, but don’t let it define their future, or your emotional state. Have faith that God has a plan, and will guide you and your pup through this. I truly believe His plan was for Margarita’s Journey to help others.
    • Keep a journal or start a blog about your pup’s journey. Each post that was written after Rita’s weekly chemo treatment included uplifting things that happened to Rita including nice gestures from others and special food treats she had that week. Doing happy activities and sharing those moments helped me celebrate all things big and small with Margarita.
  2. Embrace help from others and pay it forward when you can.
    • It takes a great deal of strength, positivity, and resilience to support your fur-kid through cancer and not have a daily major melt-down. Let others help you when they offer – accepting assistance or gifts is not a sign of weakness. People who care about you and your pup are upset about the diagnosis and may find it healing to offer their help, or to give meaningful gifts.
    • At the same time, don’t be angry with those who can’t be there for you. Not everyone is capable of sharing their emotions, and not everyone feels the way you do about your 4-legged child.
    • Use your knowledge and experiences to help others who are on a similar Journey by sharing your story. If you hear of others on the same Journey as you and your pup – reach out and let them know you are there for them.
  3. Be grateful!
    • By no means am I grateful that Margarita has Lymphoma. I am, however, beyond appreciative for the people and pups that were brought into my life as a result. Both my life and Margarita’s have been enhanced by these amazing people in our extended family.
    • Be thankful for EVERY day and for EVERY moment you have with your pup. Feelings are contagious and dogs are sensitive to your emotions. A positive attitude and a happy heart transfers to your fur-kid. Choose to be happy for every second your pup is alive!
  4. Let your faith win over your fear.
    • Some days were very difficult – both for Rita and for me. Having faith instead of worrying about what was out of my control helped me get through the toughest of days.
    • I needed something to keep me occupied and focussed and that made me feel like Rita and I were helping others who were on the same journey, so I started this blog! Each chemo treatment post referenced a powerful and meaningful quote or mantra. These words gave me the strength to help Rita through that week.
  5. You can’t take care of your pup if you don’t take care of yourself !
    • Mental and physical health is important on this journey for both you and your pup. A healthy canine body has a better chance of taking a bite out of cancer. A healthy human body has more strength to carry a canine cancer patient on their Journey. Good nutrition and healthy exercise (to whatever level is appropriate for you and your fur-kid) helps keep the mind and body alert and strong. Stay optimistic and keep moving!
  6. Never, EVER give up!
    • Research and explore all doable options
    • Educate yourself
    • Stay focussed
    • Stay positive

Monthly Primary Veterinarian Visit

On March 3 Margarita had her liver values tested again – and we are thrilled to report that all values are continuing to decrease and get closer to normal levels! Margarita will have her liver enzyme levels tested again on May 4, 2020. Because her liver is doing well, Rita’s current doses of Prednisone and Denamarin will remain the same for now.

I am currently exploring changing Rita’s probiotics from Fortiflora to Visbiome, as our primary Veterinarian, Dr. Campbell suggested Visbiome may be a better choice for Margarita’s Irritable Bowl Disorder. In addition, I am actively researching a Holistic Doctor and Nutritionist in hopes when all calms down from the Covid-19 virus, we can explore those further options with intentions to support Margarita in the most well-rounded methods possible.

Things of Note This Month

  • March 4
    • Double Digit Birthday!
    • Click HERE to see the post of her birthday activities
  • March 13
    • One year since the detailed results came back that told us:
      1. the type of Lymphoma Rita had (Diffuse Large B Cell Lymphoma)
      2. Rita’s liver showed inflammation patterns that represented chronic hepatitis
      3. Rita had a severe degree of inflammatory bowel disease, causing loss of proteins
  • March 17
    • St. Patrick’s Day
  • March 19
    • One year since we were told the details of Rita’s Diffuse Large B Cell Lymphoma
      1. Stage 4
      2. Substage A
    • First Chemo treatment 1 year ago
    • One YEAR IN REMISSION!!!!!!
  • New collar bling!

11 Months in Remission

11 Months in Remission

Margarita had a fantastic month!

Rita received another box of amazing goodies from Chewy.com from a friend of ours!

Margarita’s Aunt Jen brought her a treat from McDonalds when she came to visit

Broom Challenge accepted! Rita joined in on the magic of February 10th… and voilà!

Armageddon Brewery opened its doors, and Margarita was their first 4-legged visitor!

We had the most special Valentine’s Day ever when the Medford Lakes Police Department came to the house to help Sweet Reet check off another Adventure List item (take a ride in a police car)!

February 21st was one year since Rita’s splenectomy. While it may seem silly to celebrate having an organ removed, had her spleen remained, Rita wouldn’t be here with us today.

How about your own National Day to help celebrate 11 months in remission?! National Margarita Day was celebrated February 22nd.

At Rita’s last oncology visit, Dr. Baez (Margarita’s new oncologist) cleared her to do whatever activities she pleases. We have been incorporating longer walks into our schedule, and this month Margarita took her first hike since her diagnosis last year.

Margarita, Porter, and their cousin Clyde enjoyed a nice hike together!

Margarita has accompanied me at school many times this month. At least once a week I come home for lunch, and after all the pups go potty, Rita will head back to school with me for an hour visit with the students. The students are thoroughly enjoying her company, and Margarita is soaking up all the love, pets, and belly scratches!

February 27th was one year since we found out Margarita had Lymphoma. We are truly blessed to be able to “celebrate” this one-year mark, as we know many dogs are not as lucky as our Sweet Reet to have made it this far. She is truly a Lymphoma Warrior!

Monthly Primary Veterinarian Check-Up

On February 4th, 2020 Margarita saw Dr. Campbell and had her blood work drawn again to retest her liver enzyme levels.

The results were as follows:

ALT Normal Range: 18-121

  • Rita’s ALT Values:
    1. 1,155 (12/9/19)
    2. 1,195 (12/26/19)
    3. 924 (1/15/20)
    4. 500 (2/4/20)

AST Normal Range: 16-55

  • Rita’s AST Values:
    1. 146 (12/9)
    2. 146 (12/26)
    3. 56 (2/4/20)

As you can imagine, we were thrilled! Dr. Campbell instructed us to increase Margarita’s Denamarin and have her blood work retested in 4 weeks. Rita will visit with Dr. Campbell again March 3rd to have this test done.

Current Liver medication and supplement dosage:

  • Prednisone:
    • 5 mg in AM
  • Denamarin:
    • 1 tablet twice daily (increased from the prior 1 tablet daily)

Dr. Campbell also suggested that we contact Margarita’s cardiologist, Dr. Bossbaly, in hopes to have her chemo-induced-DCM recheck appointment moved up, and also to inquire about the possibility of taking her off of the cardiac medication, Pimobendan. The less medication Rita is on, the better…this way her liver is not overworked with processing medications.

I was not able to get a sooner appointment with Rita’s cardiologist, Dr. Bossbaly, but I was able to speak with her. Dr. Bossbaly wants Margarita to stay on the Pimobendan at least until the appointment in June because she is doing so well on it. Dr. Bossbaly does not feel this medication will have any effect on Rita’s liver values. She also said that she was concerned that if Rita’s heart disease got worse, it would have even more of effect on her liver.

Monthly Oncology Check-UP

I was surprised to find out upon her exam that she gained over 2 pounds. Last oncology visit she was 52 pounds, and this visit she weighed in at 54.8 pounds. This could be a side effect of the Prednisone, and I plan to discuss this at our next monthly veterinary appointment with Dr. Campbell. On exam, Margarita’s heart rate and rhythm were normal and Dr. Baez could detect a low-grade heart murmur. Rita’s peripheral lymph nodes were normal and she was in good body condition.

Dr. Baez said Margarita looked fantastic! I shared with Dr. Baez that I was interested in exploring nutritional options for Rita and possibly adding in some holistic care to maximize all the treatment options for her. Doctor Baez provided me with some referrals for both a holistic vet as well as a nutritionist. I plan to discuss this information with our primary veterinarian, Dr. Campbell, at our next monthly appointment.

Although I rehearsed in my head many times, the next part of my conversation with Dr. Baez was very difficult for me to say out-loud. After careful consideration of Margarita’s current level of liver disease, intestinal disease, and heart disease, Brian and I feel as though if her Lymphoma resurfaces, another round of chemotherapy would not be a fair option for our Sweet Reet. However, if those diseases improve, and she is deemed healthy enough, we would absolutely explore chemotherapy again as an option. In the meantime, we are inquiring about any and all ways we can support Rita in hopes to keep her in remission for as long as possible.

If Margarita’s liver values decrease with her next blood test, we are going to hold off on her abdominal ultrasound until June (which would be 6 months since her last ultrasound). If her liver values increase with the next test, we will order the abdominal ultrasound to be completed ASAP.

With the “1 Year in Remission Anniversary” approaching, Margarita’s oncology visits will also now change from every month to every two months until she reaches her “18-months in Remission Anniversary.” At that point we will then increase the time between oncology visits to quarterly, (every 3 to 4 months). Dr. Baez asked us to continue to monitor Rita as we have been doing, and to reach out if we have any concerns. Margarita will have her next oncology visit with Dr. Baez in April.

This Month’s Treat

This month Margarita enjoyed a small taste of Bacon, Egg and Cheese Tacos with a side of Mac-n-Cheese from TGI Fridays !

We are looking forward to March – we have some pretty amazing milestones to celebrate!

✔️ #2 Take a Ride in a Police Car 🚔

With the help of Medford Lakes Police Department’s Chief of Police, Margarita checked off Adventure List item #2 on Valentine’s Day 2020!

A HUGE thank you to Medford Lakes Police Department ’s Chief Dugan for helping Margarita check off #2 on her Adventure List! (Take a ride in a Police car 🚔). Chief Dugan was nice enough to come to our house to pick up Sweet Reet and take her for a nice long ride around town!

He also gave Margarita a MLPD patch and pin!!

We are forever grateful to Chief Dugan for creating this happy memory in Rita’s Journey through Lymphoma.

We would like to thank chief Dugan and the Medford Lakes Police Department not only for this kind and generous act, but for everything they do to keep our community safe.

10 Months in Remission; 6 Month Post-Chemo

Month 9 Remission Recap

I have to admit, at first I thought this past month was a bit of a let-down – that the elevated liver enzyme result discovered last month was a set-back for Margarita. I found myself losing a bit of hope – until I spoke to a friend who asked how Margarita was doing. When I explained to my friend what you will soon read in this month’s post, I quickly realized just how grateful I should be. Speaking with my friend reminded me just how lucky we are, as my friend had recently lost multiple 2-legged and 4-legged family members to cancer – all within a short time frame of each other. All of those family members lost their battle with cancer in much less time than Rita has been in remission. In addition, Margarita’s new oncologist instilled even more appreciation in my heart. This past month wasn’t a setback for Margarita at all … it was just a setup for an even greater comeback, as well as a reminder for me to put some gratitude in my attitude and celebrate each and every day!

This past month Margarita visited Chimney Rustic Ales , had fun playing in the yard, and enjoyed destroying stuffies in the house on rainy days.

Margarita also visited my school twice this month, bringing joy to both children and adults.

Internal Medicine Evaluation

Now just a little over a year from her first Internal Medicine evaluation, Margarita was seen by Dr. Peter Chapman in VSEC’s Internal Medicine Department on January 15, 2020.

After careful review of Margarita’s case, Dr. Chapman explained that he believes Rita’s elevated liver values are most likely caused by one of the following:

Dr. Chapmans shared that other less-likely causes of the elevated liver enzymes are as follows:

Dr. Chapman explained there are a couple of ways we could try to determine which of the above was causing Margarita’s elevated liver values:

  • empirical treatment
    1. Prednisone
      • This medication can help with liver disease
      • This medication also battles Lymphoma so it could help with Lymphoma – but would also mask that the disease is the culprit leading to other issues
    2. Cyclosporine
      • This medication has potential to prompt the Lymphoma to come out of remission
  • laparoscopic surgery for liver biopsy to gain definitive diagnosis
    • There is concern that even though this procedure would be less invasive than her splenectomy, this would still be a difficult procedure for Rita to endure so soon after everything she has been through in the past year, and given her liver and intestinal diseases
    • There is concern for anesthetic risk with Rita having chemotherapy-induced Dilated Cardiomyopathy
    • If this route is chosen, Dr. Chapman also noted that he would opt not to remove Margarita’s two mammary masses during this procedure due to the prolonged anesthesia creating a greater risk

Dr. Chapman also did a blood test while we were at this appointment and submitted a mini liver panel to see if Rita’s liver ALT value was still elevated. The test revealed the following:

ALT Normal Range: 18-121

  • Rita’s ALT Values:
    1. 1,155 (12/9/19)
    2. 1,195 (12/26/19)
    3. 924 (1/15/20)
      • Even though her ALT number dropped, 924 is still very elevated considering the normal ALT range is 18-21

ALP Normal Range: 6-160

  • Rita’s ALP Values:
    1. 447 (12/9/19)
    2. 569 (12/26/19)
    3. 444 (1/15/20)
      • Even though her ALP number dropped, 444 is still very elevated considering the normal ALP range is 6-160

Now to do our best to make the most appropriate decision for Rita….

Patiently waiting in the sitting area of VSEC for her appointment

A Difficult Decision

Although nothing about Margarita’s Lymphoma Journey has been easy, we were not expecting such a difficult decision in choosing which option is in Margarita’s best interest. After much thought and long discussions with Margarita’s medical team, we have decided to treat Margarita with Prednisone and Denamarin. Denamarin is a nutritional supplement containing the antioxidant Silybin used to improve liver function by increasing liver glutathione levels.

Dosages are as follows:

  • Prednisone:
    • 5 mg twice daily
  • Denamarin:
    • 1 tablet daily

It was easy to decide Cyclosporine is completely off the table since it has the tendency to bring Lymphoma out of remission. That part of the decision was a no-brainer.

We immediately wanted to know if Rita’s lymphoma has returned, as we are well aware that chemotherapy knocks the disease down, but does not completely rid her body of the cancerous cells. We knew that since the lymphoma originated in her spleen, the return of this disease could be difficult – and maybe even impossible – to catch in time. Although we feel the need to know if the Lymphoma is resurfacing, we don’t want our strong desire for clarification to override what is best for Margarita. Her needle biopsy with Dr. MacLeod was negative. Although the needle biopsies are sometimes not as precise as the full biopsy that laparoscopic surgery can provide, we are praying it was accurate. Putting Rita through another surgery will be a last-resort option.

If in fact we put Rita through the laparoscopic surgery and it was determined that the Lymphoma was back, Margarita would immediately be put on Prednisone anyway – so that is what we decided to try first. Margarita began Prednisone (5 mg twice daily) on January 21, 2020. We need to be vigilant in watching for any changes or additional symptoms since the Lymphoma has a higher chance of going undetected with the use of Prednisone. A recheck of her bloodwork to see if the Prednisone lowered her liver enzyme values is scheduled for February 4, 2020 with our primary veterinarian, Dr. Campbell.

Margarita’s medical team is quite confident that Rita’s elevated liver values are caused by liver disease, and not Lymphoma. We put our faith and trust in this team and are certain we made the right decision for Margarita.

The unknown is the most difficult part of this. In addition, just because it more likely to be liver disease is not a reason to be completely relieved. Liver disease could also be a life-threatening issue for Margarita. One thing we are certain of is that Margarita is a fighter. We are praying that whatever may be causing Rita’s liver values to be elevated is something that we can help her overcome.

The Start of Prednisone

Januaty 25, 2020

On the 5th day of being on Prednisone, Margarita began to exhibit some of the common side effects:

  • increased hunger, thirst and urination
  • panting

However, she also was extremely unsettled – very upset and pacing. We put a call in to our primary veterinarian, Dr. Campbell. She instructed us to reduce the Prednisone to 5mg in the morning and to stop Rita’s nighttime dose to see if it would settle her down. Luckily Margarita did not mind wearing doggie diapers, as her bladder was releasing beyond her control.

January 26, 2020

Margarita’s bladder emptied throughout the night without her realizing. She woke up Sunday not interested in food and acting lethargic. We monitored her extremely closely throughout the day. However, by that evening, Margarita was stabilized on the reduced Prednisone dosage, gained interest back in food, and did not need to wear the doggie diapers any longer.

6 Month Post-Chemo Check-up with New Oncologist / 10 Months in Remission

Margarita and I met her new oncologist, Dr. Jennifer Baez , at the Center for Animal Referral and Emergency Services (CARES) on January 28th. Dr. Baez entered the room, and immediately following introductions, smiled and said, “She’s a survivor! She’s one of the lucky ones – not everyone can celebrate that.” I immediately burst into tears. It was like Dr. Baez somehow knew I needed a little gratitude-refresher! I was overwhelmed with appreciation and happiness that we are approaching what will be one more year of being lucky enough to have Margarita in our lives.

Dr. Baez was extremely compassionate and thorough. After reviewing Margarita’s case, Dr. Baez suggested to continue monthly physical check-ups with her, and for Margarita to have an abdominal ultrasound when she reaches her “1 year in remission” date.

10 Months in Remission Check-Up with Primary Veterinarian

Margarita skipped this visit for the month of January for a couple of reasons. First, she had seen our primary veterinarian, Dr. Campbell, earlier in the month. Secondly, she will see Dr. Campbell in just a few days for the two-week blood work re-check on her liver values, where Dr. Campbell will also do a physical exam on Margarita. With Dr. Campbell’s blessing, we decided that it was best not to stress Margarita with another doctor’s appointment this month.

This Month’s Treat

Margarita enjoyed a few bites of Roadside Sliders and Sweet Potato Fries from The Cheesecake Factory !

Riding the Roller Coaster: 9 Months in Remission; 5 Month Post-Chemo

Recap of Month 8 of Remission

Since her last monthly check-up, Margarita had another remarkable month. She visited my school again, and made some students extremely happy!

The weeks that followed this classroom visit, however, have been an emotional rollercoaster ride.

Monthly Check-Up with Oncologist

On December 6, 2019, Margarita saw her oncologist, Dr. Risbon, for her recheck for lymphoma. During her appointment, I noticed that Margarita was drooling slightly while she was with the doctor, but I didn’t think much of it at the time. Her physical exam was normal and there was no evidence to suggest recurrence of lymphoma. Doctor Risbon could not hear her heart murmur on this day, and Rita’s heart rhythm was reported as normal. Dr. Risbon evaluated Rita’s mammary mass and shared that the thickened tissue portion was similar, and the mass that she could feel seems to have had no change from previously. Dr. Risbon also confirmed that she felt the new small nodule noted by Dr. Campbell during her last visit. Dr. Risbon was pleased with Margarita’s progress and deemed her to be about 9 months in remission. I was very grateful for this good report, but sad and fearful at the same time. This was Margarita’s last appointment with this oncologist, as Dr. Risbon is going on maternity leave, and then transferring to a facility that is out of driving range to our home. Dr. Risbon assured me that the new oncologist will take great care of Margarita, and also told me I could reach out to her at any time with questions on any new findings. We are very thankful to Dr. Risbon for seeing Margarita through her chemotherapy, and wish her the best while adding to her family and continuing her practice at a new location.

Monthly Check-Up with Primary Veterinarian

On December 9, 2019 Margarita had a visit with our primary veterinarian, Dr. Campbell. This visit was her monthly check up, as well as her yearly therapy dog examination. In addition, this appointment was also for bloodwork that Rita’s cardiologist, Dr. Bossbaly, requested at Rita’s last visit to test her kidney function because of the heart medication she is currently taking. Dr. Campbell examined Rita’s mammary tumors and reported that they have not changed since last visit. When Dr. Campbell asked me how I thought Rita was doing, I shared that her appetite and energy were both great. I also explained that I noticed Rita drooling slightly at her oncology appointment, and that was something I had never observed before. I almost didn’t even bring it up – but so thankful now that I did. Dr. Campbell then looked at Rita’s gums and said that they didn’t look super pale, but she just wasn’t 100% happy with the color she saw. Dr. Campbell suggested we do some additional blood work beyond the tests Dr. Bossbaly requested for kidney function. I didn’t worry too much about Rita’s gum coloring, and honestly didn’t expect much to come of the bloodwork that Dr. Campbell sent off for testing.

On December 10, 2019 Dr. Campbell called us with the bloodwork results. Much to our dismay, Margarita’s liver values were through the roof. Dr. Campbell explained that the drooling could likely be caused from nausea if something was abnormal in her biliary tract. Rita’s liver values are below:

  • ALT Normal range: 18-121
    • Rita’s ALT value: 1,155
  • GGT Normal range: 0-13
    • Rita’s GGT value: 22
  • AST Normal range: 16-55
    • Rita’s AST value: 146
  • ALP Normal range: 5-160
    • Rita’s ALP value: 447

Dr. Campbell had us schedule the first appointment we could secure with Chief of Diagnostic imaging, Dr. Alexander “Sandy” MacLeod at VSEC. The first available we could schedule was December 19, 2019. Brian and I were nervous to wait that long, so Dr. Campbell had me bring Margarita to her office that evening to do a brief abdominal ultrasound. Dr. Campbell observed that Rita’s liver and gallbladder were somewhat enlarged. She shared that this may be cholestasis caused by the “backing up” of chemo drugs. She started Rita on a low dose (125mg once daily) of Ursodiol in hopes that we’d see a marked difference at the time of her abdominal ultrasound at VSEC.

Abdominal Ultrasound with Dr. MacLeod

If you have been following Rita’s Lymphoma Journey from the beginning, you may be thinking that “Dr. Macleod” sounds familiar. That’s because Dr. Alexander “Sandy” MacLeod’s wife, Dr. Jennifer MacLeod is the doctor who performed Rita’s splenectomy.

Dr. Sandy MacLeod performed an abdominal ultrasound on December 19, 2019. Despite the Ursodiol Margarita was taking, there had been no difference in Rita’s condition. His findings were as follows:

  • Liver: Hypoechoic, mildly enlarged. 1-2 cm hypoechoic nodule in ventral left medial lobe
  • Gallbladder and Biliary Tree: Gallbladder moderately dilated with anechoic bile, no wall thickening or duct dilation
  • Spleen: absent
  • Kidneys: no abnormalities identified
  • Arenal glands: no abnormalities identified
  • Uriniary bladder: no abnormalities identified
  • Stomach: Mild thickening of pyloric wall. Mild fluid dilation of pyloric antrum
  • Intestines: no abnormalities identified
  • Colon: no abnormalities identified
  • Pancreas: no abnormalities identified
  • Peritoneum: no abnormalities identified
  • Mesentery: no abnormalities identified
  • Lymph Nodes: no abnormalities identified

Diagnosis and Recommendations:

Although I was thrilled that her lymph nodes were normal, I was devastated to hear the word “nodule.” Dr. MacLeod explained that the liver findings could be due to hepatitis , toxic insult, infiltration (recurrence of lymphoma) or other hepatopathy. Dr. MacLeod was most concerned that the findings could be the Lymphoma reappearing with a new disguise, so he recommended a guided needle aspirate of the liver nodule and its surrounding tissue for cytologic analysis, which was done during that same appointment. Dr. MacLeod shared that the mild stomach thickening and dilation is most consistent with gastritis.

We received a call from Dr. MacLeod on December 21, 2019. The first thing Dr. MacLeod said was “It’s not Lymphoma.” To say we were relieved was an understatement – hearing this was THE best Christmas gift ever! BUT…what WAS causing the high liver values, enlarged liver , thickening of the stomach, and enlarged gal bladder? This remains unknown. Dr. MacLeod suggested that we do the same bloodwork again with Dr. Campbell to compare Margarita’s liver values in a few more days to see if they corrected themselves now that Rita has been on Ursodiol for a longer period of time. He added that if the liver values do not improve, it would be time to see an Internal Medicine Specialist.

On the morning of December 26, 2019 I took Rita to or primary veterinarian’s office. Dr. Campbell drew Margarita’s blood, and sent the sample out to the lab. Later that evening, Dr. Campbell called us with the results. Margarita’s liver values had increased yet again, despite the Ursodiol she had been taking. The results are below:

  • ALT Normal Range: 18-121
    • Rita’s ALT Values:
      1. 1,155 (12/9)
      2. 1,195 (12/26)
  • GGT Normal Range: 0-13
    • Rita’s GGT Values:
      1. 22 (12/9)
      2. 22 (12/26)
  • AST Normal Range: 16-55
    • Rita’s AST Values:
      1. 146 (12/9)
      2. 146 (12/26)
  • ALP Normal Range: 6-160
    • Rita’s ALP Values:
      1. 447 (12/9)
      2. 569 (12/26)

These were obviously not the results we were hoping for. Dr. Campbell directed us to stop the Ursodiol and suggested we make the first available appointment with Dr. Klag , the Chief of Internal Medicine at VSEC. Dr. Klag is the Doctor that first saw Margarita in January 2019. Margarita has an appointment set with Dr. Klag for January 16, 2020 (his first available). I also requested to be put on a cancelation list in hopes of getting a sooner appointment. However I was told they do not do a waiting/cancelation list for the Internal Medicine department. I explained that we have been put on a waiting/cancellation list at VSEC in the past for other doctors and departments – such as Dr. Bossbaly in the Cardiology department. I expressed my frustration and disappointment to the staff member making the appointment. The woman I was speaking to informed me that Dr. Klag would return to the office from his Holiday Break on January 2nd. Additionally, I sent an email directly to Dr. Klag to inform him of the events and multiple diagnoses that have taken place since he last saw Margarita in order to explain the urgency behind our request for a sooner appointment. Lastly, I will be calling VSEC 2-3 times a day leading up to the scheduled appointment in hopes of catching a cancellation that would otherwise go unannounced due to the department’s lack of waiting list.

Although these past few weeks have been an emotional roller coaster for us, I am grateful for every single day that Rita is still riding. Brian and I entered the front seat of this roller coaster prepared for the peaks of celebrations, the abrupt falls, and the mysterious turns Lymphoma would throw at us. Positivity and vigilance are key. Although it is a scary ride, I will be keeping my eyes wide open. Had I neglected to mention that little bit of drool to Dr. Campbell, Rita’s roller coaster could have spun out of our control before we knew what hit us. I am embracing the highs and lows of this scary ride. I celebrate and appreciate each peak – and I’m accepting the plummeting falls as more knowledge that I hope will not only help Rita continue to take a bite out of Lymphoma, but also assist other pups and PAWrents in the future.

Keep those prayers coming – and buckle up – we may be in for a rough ride ahead.

This Month’s Treat

Following her monthly appointments, Margarita enjoyed a small portion of a beef and cheese quesadilla from Wawa.

8 Months in Remission; 4 Month Post-Chemo

Month 7 of Remission

Margarita had an exciting and busy month. She traveled all the way to Iowa on an 11-day trip to cheer on her brothers and sisters at the DockDogs World Championship.

Rita also checked-off another one of her adventure list items! We took Margarita to The Library II for a specially-selected cut of filet mignon! Click HERE to see her special-cut steak!

We also did our part to participate in National Canine Lymphoma Awareness Day, by publishing a post to help others understand this disease and to learn how to check your dog for signs of cancer.

4 Month Check-Up with the Cardiologist

Back in July 2019, Margarita was diagnosed with Dilated Cardiomiopathy, thought to be caused by Doxorubicon (Adriamycin) toxicity. Rita’s heart was enlarged, and she had a grade 3 heart murmur with ventricular premature contractions. On November 5, 2019 Margarita saw her cardiologist, Dr. Bossbaly for her 4-month re-check.

Rita waited patiently for Dr. Bossbaly:

Who’s that pretty girl staring back at me!?

Dr. Bossbaly did a a recheck EKG and echocardiogram. Rita’s heart murmur was graded as a 2 out of 6. The murmur was described as a wispy band shaped holosystolic murmur at the left apex, and audible only faintly on the right. Her heart rate was 118 bpm and regular, and her lungs were also clear. Additionally, there was also no arrhythmia recorded at this time on a long-recorded EKG as well as during the entire echocardiogram.

This means that Margarita’s heart disease is it stable on the current medication. Even though Margarita’s heart showed improvement, Dr. Bossbaly wants her to continue with her current medication and supplements until we have the next scheduled cardiology appointment in 6-8 months. Margarita’s current medication and supplement schedule will remain as follows:

  • Pimobendan: 5mg eery 12 hours
  • L-Carnitine: 1 gram twice daily with food
  • Taurine 500mg twice daily with food
  • Coenzyme Q10: 30 mg once daily
  • CAS Options: 1 tablet twice daily

With the indication of Margarita’s marked improvement last month, I must admit that I neglected to continue monitoring her sleeping respiratory rate (SRR), thinking it wouldn’t be necessary considering she was making such great improvements. I was incorrect. Dr. Bossbally instructed me to resume tracking Rita’s SSR. Dr. Bossbaly explained that even when improvement is noted, taking Margarita’s SSR is extremely important for anticipating fluid shifts and the onset of congestive heart failure. For those of you wondering why it is important to monitor your pup’s sleeping respiratory rate and how to count/track it, here is the information I was given:

  • Why monitoring your Pup’s respiratory rate is extremely important:
    • The sleeping respiratory rate is a subtle and sensitive indicator of changes in your fur-kid’s condition.
    • Increases in the sleeping respiratory rate may indicate the development of heart failure in your pup.
    • Your doctor will want to know if your pup’s sleeping respiratory rate goes above 30, or if there seems to be an upward trend (a steady increase in rates heading towards 30) . The point is to catch the change in the sleeping respiratory rate before it reaches 40 or 50 and could become an emergency situation.
    • Is important to note that he small increase in this sleeping respiratory rate may not be accompanied by any other changes such as an increased effort to breeze, excessive panting, coughing, or restlessness. These are important to note but it is likely that once you see the signs, the sleeping respiratory rate will already be elevated.
  • Why count the sleeping respiratory rate?
    • If your pup has been diagnosed with heart disease, it is unfortunately a progressive disease in most cases. Monitoring it on a regular basis will help avoid a health crisis; It will help avoid an emergency visit to your veterinarian, hospitalization for multiple days, and the sudden increase in financial responsibility occurring with emergency hospitalization.
    • Tracking sleeping respiratory rates every now and then is not ideal, as this number can change overnight. Additionally, just “watching” or “eyeballing” is not accurate enough.
      • **EXAMPLE: Say your pup’s sleeping respiratory rate is 24 (in 15 seconds you count 6 breaths). Now let’s say that your dogs sleeping respiratory rate increases to 32 (in 15 seconds you counted 8 breaths). The difference between the two instances is only a breaths per minute – a hard thing to notice if you’re not actually tracking the breaths. Additionally, 32 is an elevated and abnormal sleeping respiratory rate.
  • How to count the respiratory rate:
    • Count the respiratory rate by watching your dogs chest go up and down (each “up” and “down” equals one breath cycle). Use a clock or a watch with a second hand, count the number of full breaths in 15 seconds, and multiply that by 4 to get the respiratory rate for one minute. Log these results on a computer, in a journal, on your calendar, or on a note in your phone.
    • ***NOTE: We have found it easier to download a sleeping respiratory rate app. The app will help you keep count of the breaths, and also save the results and display them in a graph that you can email or share with your pup’s doctors. The two most helpful apps we have found are:
      • Cardalis: This app is free and will help you to measure your dog’s respiratory rate, record it as a graph. This results graph can be e-mailed to your dog’s doctors. Cardalis is best if you have only one fur-kid with heart disease, as it only allows for tracking of one dog/cat.
      • Maolife: This app is also free, and allows you to track the respiratory rates of multiple dogs/cats. Results are recorded in a graph. The Maolife app also allows multiple people to manage the same fur-kid. Additionally, this app has the capability to share your recorded results with others.

Lastly, I discussed the possible removal and biopsy of Rita’s mammary mass with Dr. Bossbaly. Doctor Bossbaly explained that Rita is still at a higher risk. If it becomes necessary for the mass to be removed and biopsied, Dr. Bossbaly’s suggestion is to have it done at VSEC were a board-certified anesthesiologist can monitor the protocol that Dr. Bossbaly recommends. If we would rather have the mass removed by our primary veterinarian, Dr. Campbell, the procedure can be sent over to Dr. Campbell for her to decide if she is comfortable doing the surgery along with the recommended protocol.

Monthly Check Up with Oncologist

On November 15 Margarita had a visit with her oncologist, Dr. Risbon. Rita’s physical examination was normal, and there was no evidence to suggest recurrence of lymphoma. Dr. Risbon could not hear a heart murmur today, and reported that Rita’s heart rhythm is normal. Dr. Risbon also evaluated Rita’s mammary mass and said she thought the thickened tissue portion appears to feel smaller. However, the small mass (approximately 3-5 mm) seems unchanged from previously. Dr. Risbon shared that she is pleased with Margarita’s progress, and feels as though she is doing well in maintaining her remission.

Patiently waiting for Dr. Risbon

First Day Back “on the Job” since Lymphoma Diagnosis

Margarita made a very short surprise-visit with me at my school and made some students extremely happy!

We kept the visit with the kids to only 30 minutes. The visit was perfect and did not exhaust Rita.

Margarita overseeing the students’ “Math Fact War” game
Margarita overseeing the students’ “Math Fact War” game
Margarita snoozed while the students completed their online Math assignment.
This student was so happy Rita decided to use her as a “pillow” during her nap.

Monthly Check Up with Primary Veterinarian

On November 22 Margarita visited with our primary veterinarian, Dr. Campbell for her monthly post-oncology appointment. Dr. Campbell said she was very pleased with the improvement in Margarita’s heart murmur, as well as her Lymphoma remission. While the original mammary mass was being checked, Dr. Campbell found a second tumor on a different gland.

Mammary tumors are extremely common in female dogs – especially those who were spayed later in life. Spaying a female after the first or second heat cycle significantly reduces the risk of the dogs developing a mammary tumor. Since Margarita was not spayed until we took her in as a foster at age 6-ish, we knew mammary issues were a possible issue. If you are reading this and are immediately thinking, “Why is the vet not aspirating the mass to look at the cells?”… then you are not alone. I immediately asked Dr. Campbell if we could aspirate the original mass when it was discovered. Dr. Campbell explained that unfortunately a fine needle aspiration of the mass usually has a very low diagnostic value when it comes to discerning between malignant or benign tumors. Unfortunately, the only way to diagnose a mammary tumor as benign or malignant is to surgically remove them and send the mass out for a biopsy.

The good news is that Dr. Campbell explained that approximately 50% of mammary tumors are benign. My immediate response was, “What if the masses are malignant?” Dr. Campbell informed me that even if the masses are removed and found to be malignant, there is no proven effectiveness of chemotherapy for the treatment of malignant mammary tumors in dogs. If deemed necessary, the tumors would be removed and the biopsy would tell us a more detailed story of what treatment (if any) would be needed.

I have many other questions about these tumors – such as the prognosis if they are found to be malignant. I know the best prognosis is directly associated with early detection. I decided it was best to not ask any other questions until I “have” to, and to do my best to remain positive that Margarita will be lucky enough to be included in the “50% benign” grouping. In the meantime, I am focusing on the many good days we have celebrated with Margarita, and extremely thankful that I have Dr. Campbell as such a patient and informative teacher during this process.

Margarita will continue to see Dr. Campbell on a monthly basis so that both Margarita’s oncologist and Dr. Campbell can keep a close watch on the mammary masses in order to determine the best plan for Margarita moving forward.

This Month’s Treat

Margarita enjoyed a few bites of a grilled cheese from Panera Bread!

National Canine Lymphoma Awareness Day

November 7th is National Canine Lymphoma Awareness Day. Founded in 2015 by agility dog trainer, Terry Simons, this annual event seeks to educate and create awareness for one of the most common types of malignant cancer in dogs. Terry’s beloved dog, Reveille, was diagnosed with Lymphoma in 2011, and despite many great efforts, his dog passed away a year later. In response, Terry founded the Canine Lymphoma Education and Research (CLEAR) Foundation to provide education and guidance to pet owners whose dogs have lymphoma.

Margarita at 7.5 months in remission after her Lymphoma Diagnosis

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Lymphoma is one of the most common cancers in dogs. The term “lymphoma” refers to several types of cancer derived from lymphocytes — one of the five types of white blood cells. Although lymphoma can attack any organ in the body, it most commonly presents itself in the organs of the immune system such as the lymph nodes, spleen, and bone marrow. Any breed of dog, at any age, can get lymphoma.

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The cause of lymphoma is not well understood. However, it is believed that genetic and environmental factors may play a role in bringing about this disease. Exposure to chemicals, pollutants, and toxic substances like herbicides are thought to be culprits. Subjection to radiation or electromagnetic fields may be another factor.
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National Canine Lymphoma Awareness Day reminds PAWrents to stay vigilant and to check your fur-kids regularly.

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Be their eyes. Be there ears. Be their voice. Be their HERO. Chase Away K9 Cancer provides great resources on how and when to check your pup for possible signs of cancer. 

What To Do If You Think Your Dog Could Have Lymphoma

The symptoms of canine lymphoma vary widely based on the type. In my opinion, it is always best to err on the side of caution. If your dog has symptoms that persist for more than a day or two, or if you have any reason to suspect that your dog could have a serious illness, I would encourage you to contact your veterinarian immediately.

3 Month Post-Chemo Checkup

Margarita had her monthly checkup at her primary veterinarian as well as with her oncologist…and I’m happy to report that’s there’s not much to report!

Primary Veterinarian Visit

On 10/16 Rita saw Dr. Campbell, her primary veterinarian at Old York Veterinary Hospital for her monthly check up. I reported our observations of increased energy and appetite. Dr. Campbell listened to Rita’s heart and said that she could not detect a murmur! We are very anxious to get to the cardiologist next month to see what the echocardiogram reveals. Dr. Campbell examined the mammary mass and said that she said that she did not feel as though it has changed from the last visit.  I was very pleased with this checkup!

Oncology Visit

On 10/18 Margarita saw Dr. Risbon, her oncologist at Veterinary Specialty and Emergency Center (VSEC).  Dr. Risbon listened to Rita’s heart. Like Dr. Campbell, said that she did not hear a murmur and reported that Rita’s heart rhythm is normal! Dr. Risbon also agreed that the mammary mass did not feel as though it has changed from the last visit. Dr. Risbon shared that she is very pleased with Rita’s progress and that she is doing well as she enters her 7th month in remission. Wait… SEVEN months??? I was confused. I explained that Rita had finished her last chemotherapy treatment in July, so my understanding is that October would only make 3 months in remission. Dr. Risbon explained that they count remission months from the date of diagnosis (Rita’s Lymphoma diagnosis date was March 13, 2013) when chemo is started immediately and no signs of reoccurrence are present…so this month, Rita is considered to be in her 7th month of remission!! I also learned that Dr. Risbon will be leaving VSEC as of December 6, 2019. She and her husband are having another child, so she will be relocating to a hospital near her home in order to be in closer proximity to her family. Although I very much respect that decision to relocate and am very happy for Dr. Risbon and her family, we are disappointed that we will not be able to continue Rita’s Lymphoma follow-up care with her. Brian and I will have to make a decision to travel close to 2 hours a month to continue to see Dr. Risbon, or to find another oncologist to continue following Margarita’s case. We will be discussing our decision together along with our primary veterinarian, Dr. Campbell.

This Month’s Treat

This month Margarita enjoyed a treat from Smashburger after her oncology appointment.

She had a cheeseburger topped with a fried egg!

Margarita also enjoyed some crispy Brussels sprouts!

Margarita will see both Dr. Campbell and Dr. Risbon again next month.

✔️ #7. Go Bar-Hopping in Philly 🍻

Margarita bar-hopped her way down Fairmount Avenue in Philadelphia, drinking umbrella cocktails, pink straw drinks, shots, and Jäger Bombs….

(of water of course!!!)

Jack’s Firehouse

Urban Saloon

The Bishop’s Collar

La Calaca Feliz

1st Month in Remission Recap, and 1 Month Oncology Re-Check

First Month in Remission

I am extremely happy to report that his past month has been everything we could hope for. Margarita regained her appetite, strength and desire to run and play in the yard. Her hair has filled in nicely, and her “piggy pink” pigment is returning.

Brian and I are overwhelmed with gratitude as love and support from family and friends continues to fill our hearts. I received this most thoughtful gift box from a very a special friend.

  • 🐽Pig toy because I always say Rita has a piggy nose
  • 🍸Margarita toy
  • 💎 crystal guardian angel charm
  • ⛺️Yappy camper magnet for our RV
  • 🍪bags of yummy treats
  • 🧦 GSP socks for me
  • 📖 🦖T-Rex handbook since I always say Whiskey is a cross between a T-Rex / Velociraptor!

Since out last post, Margarita also received this amazing gift basket from the office manager at VSEC who is one of the sweetest gals we have met!

We also had the pleasure of spending time with friends at a dock diving event who passed on a very personal and special gift. The weekend that Margarita ended up in the emergency room we were supposed to attend at dock diving competition. We of course had to instead stay home that weekend. Friends of ours had brought a gift for us that weekend. This past week while we attended a competition at Hog Dog Productions, we met up with our friends who gave us this very meaningful gift.

This couple got a set of these glasses because they also had a dog who had cancer, who sadly passed. We are beyond honored to have been gifted this glass, and plan to make many toasts to Margarita during her journey. The man who makes these beer glasses has a Golden Retriever named Indiana Jones, who unfortunately was diagnosed with osteosarcoma just days after his seventh birthday. You can view Indy’s Facebook page by clicking HERE where Indy’s dad shares his beloved pup’s story of cancer.

1 Month Recheck

On August 8th, Margarita saw her oncologist, Dr. Risbon for her 1 month re-check. Her physical examination was normal and we are extremely grateful that there was no evidence to suggest recurrence of the lymphoma. However, the abnormal tissue felt during her emergency room visit now has developed what seems to be an additional mass of about 5mm.

Although this was not at all what I wanted to hear, I knew that Margarita would be predisposed to mammary tumors because she was not spayed until after 6 years of age when she came to us as a GSP Rescue of NJ foster dog. Dr. Risbon explained that mammary tumors have a 50% chance of being benign and a 50% of being malignant. Ideally, the mammary gland should be removed and submitted for biopsy. In many cases, even if the tumor is found to be malignant, Dr. Risbon explained the recommendation is for surgery alone (no chemo). The prognosis is 2-3 years if the tumor is found to be malignant. Due to the Dilated Cardiomyopathy brought on by the chemotherapy drugs, if surgery is to be performed, Margarita would need clearance from her cardiologist, Dr. Bossbaly. Margarita will see our primary veterinarian next week where we will discuss whether or not surgery is an option, or if we will continue to monitor the mass each month.

I am not going to loose faith, or diminish our hope for Margarita to have many more years ahead to enjoy life as she deserves after what she endured prior to her adoption. She has survived through more situations and illnesses than most dogs are able to endure. Even through her toughest times, she has met each challenge with such grace and courage. Even if what is thought to be a mass turns out to be malignant, we are confident that Margarita will once again be victorious.

Margarita will see Dr. Risbon again next month for a recheck.

1 Month Re-check with Rita’s Primary Veterinarian

On August 14, Margarita saw our primary veterinarian, Dr. Helen Campbell at Old York Veterinary Hospital. I am thrilled to report that the murmur discovered along with the Dilated Cardiomyopathy during week 15 of her chemotherapy plan sounds to Dr. Campbell like it has significantly improved to the point of not being heard with a stethoscope! This originally was thought to be permanent damage, so we are overjoyed to hear this news! This is also great news in the event the mammary mass is removed. We have put a call in to Margarita’s cardiologist, Dr. Bossbaly, at VSEC to see if we can get a sooner appointment than the original 4-month check up scheduled with Dr. Bossbaly in November in hopes to verify her improvement and hopefully reduce or stop her heart medication, Pimobendan. We have to keep a close eye on the mammary mass. If we do not see any changes in the mass in the meantime, Margarita will see Dr. Campbell again next month for a re-check.

Post 1-Month-Check-Up Treat

Margarita stopped at Wayback Burger !

She enjoyed bites of a bacon cheeseburger and tater-tots!

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.

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.

Life Has Many Choices…Choose Hope (Last Chemo Treatment!!!)

Week 14 Recap and Oncology Visit #15

“Once you choose hope anything is possible.” ~ Christopher Reeve

Have Only Positive Expectations.” I have never had a fur-kid with canine lymphoma before, and although Margarita is the one going through THE toughest battle, it certainly was a challenge for me as well.  This rollercoaster-of-a-time has included “lows” of gut-wrenching fear, as well as many “highs” of extensive hope. I realized that especially for Margarita’s sake – if I wanted her to have THE best chance at taking a bite out of cancer and making it though all 16 weeks of the chemotherapy plan, I had no choice but to choose hope over despair, focus on positivity, and start believing something good will come of this unfortunate situation. But HOW was I going to Have Only Positive Expectations as my beloved fur-child is battling her way through Lymphoma? Here’s how hope helped me:

  • Finding the courage to put my trust in Rita’s medical team and the science behind chemotherapy promoted my hope for a favorable outcome.
  • Maintaining hope encouraged me to not take one single second of any day for granted, and celebrate the little things every day, creating happy memories to look back on in the future.
  • Finding hope in the desire to make sure Rita still did the things she loves (when she was feeling up to it of course) fostered productive thoughts for her life-after-chemo.
  • Talking with others who have canine cancer survivors built-up my hope and boosted my capability to have constructive notions about Rita’s destiny.
  • Having hope that each day would be better than the one before and that each sunrise would bring Rita closer to taking a huge bite out of cancer cultivated promising beliefs. 
  • Planning future adventures for Rita provided me with hope and encouraged me to have feelings of optimistic possibilities.
  • MOST importantly, hope fueled my positive attitude, which ultimately helped Rita feel protected during a difficult, confusing and insecure time for her.  

Lastly, I hope that sharing both human and canine experiences, the information and resources I found to be beneficial, and the strategies that helped me stay positive will assist someone else in walking their pup through a difficult journey.

I have not been strong – or positive – or even hopeful – every moment during these past 15 weeks.  I have never cried so much and so hard as I have in the last few months. Yet the number of times I smiled overpowered my tears thanks to the support, generosity, and continuous acts of kindness from the wonderful people in my life – some I have known for a long time, and others I have met more recently through our fur-kids.  It’s absolutely amazing to me how dogs bring people together, strengthen family bonds, and create new friendships.

This week I received several more very special gifts from friendships forged by Cello’s Corner.

The first was from a friend whose dog was also diagnosed with cancer. We have been corresponding regularly about our experiences, supporting each other through this difficult process.  It just so happened that this gal’s pup is being treated at the facility where we have been taking Hooch to use the underwater treadmill.  At Hooch’s last appointment, there was a gift bag waiting for me…Within the note, our friend included, “Your attitude towards these challenging times is very Zen!” …and in the beautiful gift bag was an adorable ceramic pup in the half-lotus pose.

This pup even looks like our Sweet Reet!

This half-lotus-posed-pup will surely help me maintain serenity in our home as we move forward to life-after-chemo with Margarita.

The second wonderful surprise this week was from my friend who made Margarita’s Lymphoma Awareness collar.   I have even been lucky enough to meet this gal and her wonderful pups in person as they began their obsession with dock diving at the end of last year’s season!  This friend sent personalized decals that she made herself for Brian and I to put on our vehicles!

How amazing are these?!?!

 

I love one of the statements written in the card:  “The Reet Fleet needed to be outfitted to indicate that there is a warrior on board.”  I can’t wait to apply these awesome decals to the windows of our cars and RV!

A third gift was planned to be given by friends at the dock diving event we missed this passed weekend. Because we could not make the event due to the medical issues that arose this week, these friends messaged us with the photo below and told us that they would be saving this glass for us for the next time we are all together. We met this couple at a DockDogs competition, and sadly, they had a fur-child with cancer as well. This amazing couple has checked in constantly with us to see how Margarita is doing, and how Brian and I are holding up. Their support and prayers have contributed a great deal to our entire family’s well-being.

The man who makes these beer glasses has a Golden Retriever named Indiana Jones, who unfortunately was diagnosed with osteosarcoma just days after his seventh birthday. You can view Indy’s Facebook page by clicking HERE where Indy’s dad shares his beloved pup’s story of cancer.

I am so appreciative for these gifts – but even more grateful for the friendships!  These wonderful surprises surely lifted my spirits during one of my toughest weeks.

Week 14 Recap

If you follow us on Instagram or Facebook, you already know that Margarita had a trip to the Emergency Room last Saturday.  Last week Margarita had her oncology appointment and chemotherapy on Wednesday, June 19.  By Thursday morning, she was not looking like herself.  She would not eat her breakfast, and became continuously more lethargic as the day progressed.  When she was outside, she was trying to eat grass to induce her own vomiting, and she did not eat her dinner.  Luckily, she was still drinking little bits of water throughout the day.  Friday  – same thing – she would not eat, and didn’t have an interest in getting up from her bed.  I called VSEC to notify them of what was going on, and the Emergency Room nurse told me to bring Rita in on Saturday morning if she was still not improving.  Brian and I were supposed to attend a dock diving competition Saturday and Sunday at a somewhat local event about an hour from our home.  However, when we woke up Saturday morning, Margarita appeared even more lethargic and again was not interested in food.  I also noticed a lumpy area near one of her mammary glands.  I texted a friend to have the event administrators scratch us from the competition, and I headed out to the Emergency Room at VSEC with Margarita.

Saturday, June 22

Upon arrival to VSEC, Margarita’s vitals and CBC were normal.  This was a great sign, but she was barely moving and was shivering.  I held her on the floor for a bit, and then one of the front desk staff members brought us a big fluffy blanket for Rita to use as a bed, and another blanket to cover her for warmth.

The nipple where the mammary lump was began leaking fluid, and a newly developed heart murmur was heard.  Subcutaneous fluids were given for dehydration, and Dr. Frankel, The ER doctor on staff, called Margarita’s oncologist (Dr. Risbon) to let her know what was going on.  Both Dr. Risbon and Dr. Frankel thought it was best that Margarita stay the night in the ER for IV fluids and observation.  Although it was very difficult to leave her at the hospital, I knew she was in the best hands possible.  As I held Margarita and cried, Dr. Frankel said how sweet Margarita was and that he understands how unfair it is that she has to go through this.   He assured me he would care for her as if she was his own, and shared that he has a Pointer-mix at home.  It was a very long, emotional day filled with many tears, but Dr. Frankel and all of the staff at VSEC that day were so kind and comforting – I cannot thank them all enough.

Brian called to check on Margarita after a few hours of me leaving her, and the ER nurse reported that she was resting comfortably, and even ate a few pieces of chicken. We were thrilled with this news!

Sunday, June 23

The nurse Saturday evening told Brian that we could call Sunday morning after 9 or 10 am to check on Rita.  Of course we called at 8am ..HAHA! The doctor luckily had already evaluated Margarita.  The doctor reported that Rita was more alert and had again ate some chicken, so she was comfortable sending Rita home as long as we were going to monitor her the rest of the day.

When I arrived at VSEC, the ER nurse reviewed Margarita’s discharge papers.  We were to monitor her for progressive lethargy, lack of appetite, vomiting, or diarrhea.  If those symptoms persist, we would have to contact our primary vet or VSEC for further advice and supportive care for Margarita.

After I arrived back home with Margarita, she again had no interest in eating for us Sunday afternoon and evening.  She did seem in better spirits, and enjoyed some Sunday porch sittin’.

Monday, June 24

Still no appetite.  We called our primary vet, Dr. Campbell at Old York Veterinary Hospital.  It was suggested that we bring Rita in to see her.  Dr. Campbell did a physical exam and took some chest x-rays. Dr. Campbell noted that she did in fact now hear a heart murmur, and it was a significant change.  Dr. Campbell also told me that she felt some extremely firm stool in Rita’s bowel. Dr. Campbell called VSEC to leave a message for Dr. Risbon, and to see if we could get an appointment with the cardiologist at VSEC to evaluate Rita’s sudden onset of a heart murmur. Dr. Campbell also instructed me to give Rita lots of fluids and walk her often throughout the rest of the day to see if we could get her bowels moving.

A cardiology nurse from VSEC called me in the afternoon to let me know they could fit Rita in on July 3rd.  This worked out well since she also has an ultrasound appointment and blood work both scheduled that same day as her projected 16th oncology appointment.  If all goes well, July 3rd would also complete the CHOP plan for Rita.

Rita did drink water – and even drank some homemade chicken broth.  I walked her, and although she had some difficulty, she had a bowel movement.  I offered her liquids throughout the day and walked her again in the early evening, at which point she had another bowel movement.  She had some trouble, but was able to pass some very firm stool.

I bought some chicken, a few beef bones, and some goat’s milk.  Margarita did drink the goat’s milk, so I was thrilled.  I cooked the chicken and soup bones in two separate slow cookers for experimenting with Rita’s appetite tomorrow.

Tuesday, June 25

Rita ate a few pieces of the slow-cooker chicken, but was more interested in the broth.  She did also eat a few pieces of the bone marrow, but was not interested in the bone broth.  I continued to offer chicken, bone marrow, both broths, and goat’s milk throughout the day.  She was not able to have a bowel movement during the day.

Wednesday, June 26:  Oncology Visit #15

Margarita’s CBC was normal.  Dr. Risbon was able to hear the heart murmur, and suggested that we move forward with an echocardiogram next week.  Dr. Risbon also felt the irregular tissue on Margarita’s right 5th mammary gland.  She said that it did not feel like a mass, but more like thickened tissue, and it was not producing a discharge today.  Dr. Risbon explained that a needle aspirate is not sensitive enough to distinguish the difference.  She would recommend finishing the course of the antibiotics that were administered at our ER visit the is past weekend.  We could consider having the tissue removed and/or biopsied in the near future.  Margarita is scheduled to have an ultrasound, echocardiogram, and blood test next week.  Her echocardiogram appointment was moved up to Monday morning so that Dr. Risbon and Dr. Campbell will have all the information needed to formulate a plan for long-term monitoring.

This Week’s Treatment (LAST ONE!!!)

Considering the week Margarita had, I was surprised that Dr. Risbon suggested moving forward with this week’s treatment.  I had mixed emotions about moving forward …While I was so relieved that Rita was blessed enough to have made it through the entire round of chemotherapy that some dogs are not as lucky to complete, I was extremely nervous wondering if Rita’s body had become too exhausted to take another treatment.  Because of the newly discovered heart murmur, the additional symptoms Margarita had exhibited, and the fact that the drug she was supposed to receive today (Adriamycin) can cause toxicity on the heart, Dr. Risbon substituted a different drug (Mitoxantrone) which has less potential to affect the heart, but is still very effective against lymphoma.  The other benefit of Mitoxantrone is that there is less chance of GI side effects.  Dr. Risbon also dispensed Cerenia and Metronidazole for us to have on hand in the event Margarita displays signs of nausea or diarrhea.

This Week’s Treat

This week we stopped at Applebee’s.  I bought Margarita a corn dog, mozzarella sticks, and mac-n-cheese.

She wasn’t very interested in any of the food this week, as she was still feeling a bit nauseous, so I packaged them up in hopes of her enjoying these treats later.

I had also planned on doing something special to celebrate Rita making it through the complete round of chemotherapy, but because she was not feeling well, we have postponed that celebration until we observe that she is feeling up to PAWtying.

Margarita also now has an Adventure List!  I am not setting a time-frame in which to complete the list, I am just going to enjoy working our way through these escapades as the opportunities arise.  Hopefully I will also be able to find some friends who can help Margarita check-off these adventures!

 

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

 

 

 

Margarita Featured in BluePearl’s Newsletter

Margarita’s Lymphoma case and how it was “accidentally” discovered was very unique.  BluePearl, owner of VSEC, contacted me to see if they could feature Margarita in their newsletter, and of course, we said yes.  Below is the story published by BluePearl:

 

Last January, the Beadlings woke up to what would later lead them to a life-changing discovery: Margarita’s canine lymphoma.

LEVITTOWN, Pa. – On the night of January 7, Jenny and Brian Beadling were suddenly woken up by their beloved English Pointer, Margarita (Rita). Rita was pacing anxiously around the bedroom, urinating uncontrollably, and refused to eat. Worried by this unusual behavior, Jenny called their veterinarian the next morning and made an appointment for that evening.

Dr. Helen E. Campbell, veterinarian and owner of Old York Veterinary Hospital, examined Rita and ordered an ultrasound and bloodwork. Results showed that Rita had a 2.5 cm splenic mass and was anemic. Realizing that the symptoms may be caused by something more, Dr. Campbell referred Jenny and Brian to Veterinary Specialty and Emergency Center (VSEC) in Levittown, Pa.

After consulting with a radiologist and an internal medicine specialist at VSEC, Jenny and Brian met with VSEC veterinary surgeon, Dr. Jennifer MacLeod. Dr. MacLeod reviewed the case and recommended that Rita undergo exploratory surgery to remove her spleen, and have a biopsy of her liver and intestines.

“Unlike children, pets can’t tell you where it hurts, or how they’re feeling, so that makes our job as parents and the veterinarian’s job very difficult,” explained Jenny. “In Rita’s case, we had to rely solely on observed behavior and diagnostic testing. Although Brian and I were worried about the procedures, we were hopeful that the results would bring us closer to a diagnoses.”

To Jenny and Brian’s disappointment, malignant cells were found in Rita’s spleen and on March 13, she was diagnosed with Diffuse Large B Cell Lymphoma. At this time, Rita was also diagnosed with chronic hepatitis and inflammatory bowel disease (IBD).

“Brian and I were in disbelief when we were informed of her diagnosis,” Jenny noted. “But we knew that she was in really good hands. Not only did Rita’s medical team take time to answer all of our questions, but with each response, we felt more confident, empowered, and mentally prepared to assist our fur-child in fighting the most difficult battle of her life.”

To improve Rita’s overall health and make her better equipped to handle cancer treatment, Dr. Campbell prescribed her steroids and put her on a specific diet aimed to treat canine IBD.

Once Rita was ready to begin cancer treatment, the Beadling’s were again referred to see a specialist at VSEC. This time it was oncologist, Dr. Rebecca Risbon. Dr. Risbon explained Rita’s diagnoses of Stage IV/A Lymphoma and recommended chemotherapy.

“The duration of the treatment depended on the type of cancer, the extent of the disease, and how responsive Rita would be to the treatment,” said Dr. Risbon. “Working closely with Jenny’s veterinarian, we determined the best plan for Rita, which, in addition to the chemotherapy, included additional exams and tests such as blood work and ultrasounds to monitor her overall health and cancer status,” Dr. Risbon explained. “Any changes in Rita’s eating, drinking, or elimination habits, signs of illness, or changes in behavior are relayed from Jenny to her veterinarian, and then onto myself. It’s a necessary partnership that leads to better patient care and outcomes.”

Today, Rita is on her final weeks of chemotherapy. As a reward after her weekly appointments, Jenny treats Rita to a “cheat day,” which has included licks of a Rita’s peanut butter milkshake, bites of a Taco Bell cheesy roll up, and nibbles of a Wendy’s cheese burger.

By working collaboratively, Dr. Campbell and VSEC specialists got to the root of Rita’s unusual symptoms, and developed a customized treatment plan that they hope will extend Rita and the Beadling’s time together.

“Brian and I are grateful to have had such an amazing medical team to educate and guide us through this difficult process,” Jenny expressed. “As Margarita approaches the home-stretch of her chemotherapy plan, we are hopeful that her future will not only bring us many more occasions to spoil our fury kid, but also open up opportunities for her as a registered Therapy Dog to comfort and inspire others experiencing similar challenges.”

Be a Warrior, Not a Worrier

Week 13 Recap and Oncology Visit #14

“Worrying does not empty tomorrow of its troubles. It empties today of its strength.” ~Corrie Ten Boom

Margarita has been the ultimate Warrior.  Both her primary veterinarian, Dr. Campbell,  as well as her oncologist, Dr. Risbon, have told me that Margarita is doing much better than some dogs do when going through chemo.  Not only do some dogs have many more or worse side effects, but some dogs unfortunately aren’t even able to complete the 16-week plan for different reasons.  I am in awe of Sweet Reet’s strength and resilience, and she has inspired me to transform my worrier tendencies into Warrior energy these past 13 weeks.

As her PAWrent, it was extremely difficult at times over the last 13 weeks to clear my mind of distress, transform that negative energy into the positive strength needed to make clear decisions, and to physically and emotionally assist Margarita in her most important battle.  Keeping a calm, upbeat demeanor was important to me, knowing the vibes I emitted would undoubtedly transfer to Margarita.  A positive attitude and a calm, gentle peaceful voice made her feel happy and secure.  Like all dogs, Margarita is extremely sensitive to silent communication as well – so it was just as important for me to keep my mood and body language optimistic, despite the anxiety and heartache that I felt.

However, the mind is a treacherous battlefield, and if I was not careful…if I let my guard down jus a little…the Warrior in me disintegrated into a worrier instantaneously. So what have I done to help train my heart and mind to be a Warrior like Sweet Reet?  Call me crazy – but I watched Rita – closely.  Despite not feeling well 100% of the time, I saw Rita still take joy in small things.  Undeterred by the side effects of chemo, she still woke up with her tail wagging and happy to be alive.  Her bravery and endurance truly inspired me to start each day anew with an optimistic mind and happy heart, no matter what transpired the day before.  How do you like that? SHE was the one going through battle, yet she was helping ME all along…A true example of a Warrior.

Week 13 Recap

The week following her treatment day was great.  Margarita did not have any reactions to the Vincristine, and was feeling well enough to enjoy a trip to Maine with us.  The hair from her splenectomy surgery area has not grown back yet – which we kind of expected. But more recently, Margarita has had a bit of hair loss in her face, and some pigment discoloration in her muzzle.  Below are not the best of pictures, but I tried to show a “before'” (left side) and “current” (right side) for comparison.

We first noticed that her nose, the skin around her eyes and lips, and her muzzle were all turning darker:

Then we noticed hair loss on her face…

…and on her muzzle:

Definitely some noticeable changes – but still one of the prettiest gals we know!

Oncology Visit 14

Margarita’s CBC revealed a very mild drop in her white blood cell count, but the levels were still acceptable for continued therapy. Her physical examination was normal, and her weight was stable.  Dr. Risbon said that after the chemotherapy is completed, Margarita’s hair should fill back in, and she should regain the original pink coloring in her muzzle.

This Week’s Treatment

Dr. Risbon changed the treatment for today.  Rita was supposed to have Cyclophosphamide today.  However, the last time Rita had Cyclophosphamide, she displayed was suspected to be  sterile hemorrhagic cystitis , a side effect with this drug seen in about 10% of dogs.  To be sure this didn’t happen again, the Cyclophosphamide was substituted with Chlorambucil .

This Week’s Treat

This week’s treat was extra special.  Margarita surprised her 2-legged cousin, James on his last day of school!

First car in the Parent Pick-Up Line!

Margarita was patiently waiting for James.

James was happy and surprised to see Rita when he opened his door!

Rita’s Grammy drove us all to get a treat.

We went to Evergreen Dairy Bar . This well-known restaurant and ice cream stand opened in 1949 and is a popular spot for locals, as well as road-trippers passing by on their way to or from the Jersey Shore.

James and Margarita enjoyed a hot dog for lunch.  As you can see, Rita thinks her lunch is lip-smackin’-good!

Diggin’-In!

After lunch, James and Margarita also enjoyed a delicious ice cream treat!

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

 

Believe: Let Your Faith Be BIGGER Than Your Fear

Week 12 Recap, and Oncology Visit #13

Believe…Accept what is, let go of what was, have faith in what will be.

As Margarita moves into her last 3 weeks of the CHOP plan, I must admit I let fear start to creep in.  What if when the treatments stop the cancer comes back? If the Lymphoma does come back, how long do we have left with Sweet Reet?  I realize that negative feelings like fear and anxiety are normal emotions when dealing with a loved one who has cancer, but living with the uncertainty will not be easy.  Eliminating these limiting thoughts will be extremely important in the upcoming weeks.  Believing in my faith and Rita’s medical team will put myself in the best position to not only make it through this difficult time myself, but also to ensure that Rita is in the best spirits possible. The power of belief is an amazing thing. Countless stories describe how believing has helped people accomplish goals that others have considered impossible. It would be foolish for me to believe that every story ends happily, no matter how much faith and belief is exercised. However… I am going to choose to believe that Margarita still has many happy chapters to add to her story.

Week 12 Recap

Margarita had another great week, other than her putting her paw down about her special diet for her intestinal disease.  Rita decided that she had enough of her special diet and would not eat.  At first we thought she was experiencing nausea as a side effect of her treatments, but we quickly realized that was not the case when we offered her other options and she gobbled them down!  Originally we were going to wait-her-out until she ate her special diet, but after speaking with our primary vet, Dr. Campbell as well as Rita’s oncologist, Dr. Risbon, they agreed that it was best for Rita to eat what she wanted to eat rather than miss an meals during this important time of her treatment schedule.

This week, Margarita received an incredibly thoughtful gift. A past Pointer Rescue, Org adopter had this beautiful piece of artwork made just for Margarita!

This Week’s Treatment:

Margarita ‘s physical exam showed no abnormalities, and her CBC was acceptable for continued therapy.

Next week she is due for cyclophosphamide.  Since this is the drug that is suspected to have caused the side effects at the last dosing, Dr. Risbon will be changing Rita’s chemo drug in order to avoid further irritation to her bladder.

This Week’s Treat:

This week Rita visited Taco Bell! She had a few bites of their Cheesy Roll Up !

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

 

 

Happy, Alive, and Built to Survive

Week 11 Recap, and Oncology Visit #12

“A positive attitude gives you power over your circumstances instead of your circumstances having power over you.”

Week 11 Recap

We don’t have much to report this week other than Margarita had a good week so far and is officially moving into her last 3-week round of chemotherapy!

The sky last night was pink for Sweet Reet!

Oncology Visit #12

This week was Rita’s “off-week,” where she just had to visit the oncology office for blood work.  Her test results revealed no abnormalities, and another CBC will be repeated prior to her treatment next week.

This Week’s Treat 

Brian and I took Rita to Rita’s Italian Ice !

Rita waited patiently in the truck as her Pop was in line ordering her a yummy treat.

Margarita enjoyed some licks of a peanut butter milkshake!

YUMMY !!!!!!!!!

***REMEMBER***

Early detection is paramount. Stay informed, remain observant, pet your dog often to check for abnormalities, and take your pup to your family veterinarian regularly. If you are not sure how to check your pup for the more obvious cancer signs, click HERE for a comprehensive guide. Please also remember to take into consideration any other observations that may be out of the ordinary such as:

  • abnormal swellings that continue to grow
  • sores that do not heal despite antibiotics by mouth or an ointment applied topically
  • weight-loss that cannot be explained by a weight-loss diet
  • loss of appetite
  • difficulty eating and/or swallowing
  • bleeding or discharge from any body opening
  • offensive odors
  • reluctance to exercise or loss of stamina
  • persistent lameness or stiffness
  • difficulty breathing, urinating, or defecating

 

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

When Cancer Bites, Bite Back

Week 10 Recap and Oncology Visit #11

“There will be roadblocks, but we will overcome them.” ~ DJ Khaled

Cancer tried to take another bite out of Reet this week, but she bit back!  The dogs were outside enjoying the beautiful weather this past Memorial Day Weekend on Saturday evening.  Margarita was laying in the grass when she suddenly popped up and nervously began to pace, pant, and spin.   It quickly became apparent that she was straining to urinate.  We knew the drug used in her last chemo treatment (Cyclophosphamide) causes sterile hemorrhagic cystitis  in approximately 10% of the dogs.  Symptoms include straining during urination, urinating small amounts frequently, incontinence, or blood in her urine.  She had this same treatment during week 2 of her chemotherapy, and did not have any complications.  However, what we were observing was exactly what we were cautioned to look our for.  We followed the protocol and called VSEC to share our observations, and their suggestion was to bring her in to the emergency room for evaluation.

On the way to the ER

While Rita was at VSEC, they performed the following:

  • Physical exam
    • No concerning findings
  • Ultrasound
    • Revealed that her bladder was slightly inflamed
  • Blood work to check her kidney and liver values
  • Urinalysis
    • Results were normal

ER Treatment:

Know What to Expect

Nice try, cancer – but this was just a hiccup, and won’t hold Margarita back in her progress. I had prepared my self each week for Rita’s chemo treatments by reviewing the side effects for each week’s drugs with Rita’s oncologist, Dr. Risbon.  Each week I show up with a notebook and pen ask what side effects to expect, in what time frame we should see symptoms, and what to do if Rita begins to feel poorly.  I also often refer back to the “What to Expect” list I was given during our first oncology appointment. This keeps my mind from racing and reduces my anxiety if I happen to see something out of the ordinary.

More Ways to Help Your Fur-Kid Take a Bite Out of Cancer:

Chemotherapy kills the cancer, but also is extremely harsh on the body.  During chemo – especially during the “hiccups” that may arise – we wanted to be sure Margarita’s body was as equipped as could be to fight these little “side battles” if needed.  After speaking with others who have been through chemotherapy with their fur-kid, Rita’s primary veterinarian, and her oncologist, we chose a special diet and specific supplements to best prepare Rita’s body for it’s best defense against the chemotherapy and possible side effects.

Diet

There are many articles that suggest certain diets for canine cancer patients (most are carbohydrate-free / sugar-free diets).  However, Margarita is a unique, complex case, and therefore is on a special prescription diet due to her intestinal disease. Other than her weekly “cheat day” after her chemo appointment, we stick to her special diet as close as possible.  Every dog’s nutritional needs before, during , and after cancer and through chemotherapy are unique,  and should be discussed in detail with your primary vet as well as your pup’s oncologist.

Supplements

We chose to add supplements to Margarita’s diet to help strengthen, support, and balance her immune system.  Just like the main diet, supplements should be discussed with your primary vet and your dog’s oncologist as to which ones are appropriate for your pup’s individual needs and diagnosis.  Also be sure to ask your oncologist about a schedule of administering these supplements, as some antioxidants and ingredients will decrease the effectiveness of the chemo if given too close before or after your fur-kid’s treatment day.  Here are the supplements we chose for Margarita:

  • Fish Oil
    • Shown to improve survival times slightly in dogs with Lymphoma by helping to boost the immune system
  • CAS Options
    • A powerful blend of four functional mushrooms: Maitake, Reishi, Shiitake, and Turkey Tail,  combined with antioxidants to provide extra strength immune support. Formulated to support and balance the immune system to promote overall health and well-being for pets, especially during times of stress
  • Nupro Silver
    • Holistic product, it will provide your dog with the full range of vitamins, minerals, enzymes, amino acids, and essential omega fatty acids which promotes optimal overall health and well-being
  • Natural form bee pollen
    • Known to help reduce side effects of chemotherapy
      • Be sure to choose unprocessed
  • Probiotic
    • Beneficial bacteria that can exhibit anticancer properties.
    • Margarita also has an intestinal disease so the safe and effective strain of beneficial bacteria in a probiotic promotes and restores normal intestinal microflora for her.

Oncology Visit # 11

Margarita’s physical exam was normal, and her blood work displayed appropriate levels to continue chemotherapy.  Rita’s oncologist, Dr. Risbon, suggested that we continue the Rymadyl and Oxybutynin Chloride until next week’s visit to help with her bladder issues.  Dr. Risbon was not overly concerned about Rita’s elevated ALT value.

Treatment

During this week’s treatment, Margarita received Adriamycin intravenously.

  • We are to monitor the site for any inflammation, oozing, or discharge.
  • Side effects of this treatment may cause nausea, vomiting, loss of appetite, and/or diarrhea.
    • As  a preventative, we were sent home with:
        1. Cerenia 24 mg
          • To be given (2 tablets) once a day for 5 days to prevent nausea/vomiting
        2. Metronidazole 250 mg
          • To be given (1 tablet twice a day) at the first sign of loose stool/diarrhea

This Week’s Treat

This week’s cheat day was a visit to Wendy’s !

Margarita enjoyed a few bites of a bacon cheese burger and a couple of chili cheese fries!

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

 

No One Fights Alone

Week 9 Recap and Oncology Visit #10

“When someone has cancer, the whole family, and everyone that loves them does too.”  ~Terri Clark

When we first found out about Margarita’s diagnosis, there was no question or hesitation for us to put all other things on hold if needed, and fight right alongside Rita in her biggest battle.  We vowed to do anything we could to help our 4-legged family member survive, as long as her medical advocates deemed the actions appropriate to continue to improve Rita’s quality of life. We are extremely fortunate to have an amazing medical team behind Rita, whom we trust wholeheartedly.  Our family has been understanding, encouraging, and sympathetic. Additionally, thanks to dog sports and social media, we are beyond blessed to have a large network of extended family and friends who have not only been equally supportive, but also have been invaluable resources.

That doesn’t mean we haven’t come across those who do not understand, or cannot relate to our efforts or our bond with our 4-legged family member.  I’ve been asked by people who don’t know our family well:  “You’re getting chemo for your…DOG?!?!”… “Is it really worth it?” … In keeping the tone of Margarita’s documented journey positive, I won’t even go there – just consider yourself extremely lucky if you are like us and have friends and family who support your efforts to help your fur-child fight such a serious disease.  At the same time, be prepared as a PAWrent to be criticized or questioned by those who “don’t get it,” and think your 4-legged child is “just a dog.”

———————————————————————–

JUST A DOG

From time to time, people tell me, “lighten up, it’s just a dog,” or “that’s a lot of money for just a dog.” They don’t understand the distance traveled, the time spent, or the costs involved for “just a dog.”

Some of my proudest moments have come about with “just a dog.” Many hours have passed and my only company was “just a dog,” but I did not once feel slighted.

Some of my saddest moments have been brought about by “just a dog,” and in those days of darkness, the gentle touch of “just a dog” gave me comfort and reason to overcome the day.

If you, too, think it’s “just a dog,” then you will probably understand phrases like “just a friend,” “just a sunrise,” or “just a promise.”

“Just a dog” brings into my life the very essence of friendship, trust, and pure and unbridled joy.

“Just a dog” brings out the compassion and patience that makes me a better person.

Because of “just a dog,” I will rise early, take long walks and look longingly to the future. So for me and folks like me, it’s not “just a dog” but an embodiment of all the hopes and dreams of the future, the fond memories of the past, and the pure joy of the moment.

I hope that someday they can understand that it’s not “just a dog,” but the thing that gives me humanity and keeps me from being “just a woman.” So the next time you hear the phrase “just a dog,” just smile–because they “just don’t understand.”

~Author Unknown

———————————————————————–

If you cross paths with those who don’t quite understand the love you have for your fur-child, you may start to doubt yourself – or may wind up feeling alone and helpless. In addition to the possibility of unsupportive friends and family, you could have financial constraints or other situations that may make chemotherapy difficult or impossible.  Remember:  NO ONE FIGHTS ALONE! There is support in each area that you can find elsewhere to assist you in your part of the battle to save your pup.  First and foremost, ask your veterinarian and/or oncologist if they can suggest any helpful and reputable emotional and/or financial support groups.  I’m sure there are others out there if you search, but below are some options for emotional, informational and financial support that I found either through a friend’s suggestion, or a quick Google Search.

Emotional or Informational Support:

  1. Put out a post on social media
    • You will be surprised at how many others have been through cancer with their pup, and can provide some very helpful tips and information
  2. Pick up a copy of The Dog Cancer Survival Guide
    • This book was recommended to us by a friend of ours whose dog also battled cancer
  3. A list of suggested reading from Help Your Dog Fight Cancer :
  4. Watch The Dog Cancer Series
    • Also recommended to our by a friend of ours whose dog also battled cancer
  5. Join a Facebook support group such as the examples below or search for groups on Facebook specific to your dog’s needs:

Financial Support 

  1. If you have pet insurance, contact them to see what they will cover
  2. Apply to CareCredit.
  3. Attempt to secure a bank loan.
  4. Contact the organizations below, or search for others:
    • The Magic Bullet Fund
      • Nationwide financial assistance for people who have a dog with cancer but cannot afford treatment costs.
    • The Pet Fund
      • Assists owners in covering medical costs beyond the normal expenses of vaccination, spay and neuter surgeries, food and routine veterinary care.
    • Brown Dog Foundation
      • This organization is dedicated to helping families who find themselves in a temporary financial crisis at the same time their pet requires life-saving treatment or life-sustaining medications.
    • The Onyx and Breezy Foundation
      • This is a privately run nonprofit started in memory of the founder’s dogs.  This foundation has helped animals in a variety of ways: from spay/neuter programs, to getting dogs on death row out of high-kill shelters, to providing emergency medical care to animals whose owners have fallen on hard times.
    • Breed-Specific Support
      • There are many rescue groups and associations that support specific dog breeds. Reach out to your local breed clubs for information on local, state and national groups involved in dog breed-specific veterinary care assistance programs. Examples include groups like CorgiAidSpecial Needs DobermansLabMedPit Bull Rescue Central.
    • Joshua Louis Animal Care Foundation
      • Assists owners of pets who are in need of cancer treatment.
    • The Mosby Fund
      • Provides financial assistance for dogs in need of critical care.
    • The Riedel & Cody Fund
      • Provides hope, knowledge and funding for owners of companion animals diagnosed with cancer.
    • RedRover Relief
      • Assists animals in crisis through emergency sheltering, disaster relief services, financial assistance and education.
    • Rose’s Fund
      • Financially assists pet owners and Good Samaritans who have an animal with a good prognosis for a healthy life, but are at a financial loss.

Week 9 Recap

The week following Oncology Visit #9 was a good one!  Rita experienced some mild diarrhea on day two after her treatment, but one Metronidazole did the trick, and she had normal bowl movements the rest of the week leading up to oncology visit #10.

If you have been following along with us for a while, you are probably tired of hearing me say how blessed we are to have found ourselves involved in GSP Rescue of NJ , Pointer Rescue, Org ,  and  DockDogs – and our ever-growing extended family that came about because of those groups.  I am blown away with the continued friendship, support, motivational messages, prayers, gifts, and gestures from these wonderful people.

This week, one of our extended-family members who attends daily mass lit a candle for Rita and prayed to St. Rita of Cascia on the St. Rita’s Feast Day this week (May 22).

Another one of our extended-family members sent us two of the “No One Fights Alone” Lymphoma bracelets from the Delmarva DockDogs Canine Cancer fund raiser she orchestrated in the name of our Sweet Reet at the last Delmarva DockDogs event.  This amazing woman had no idea that my “theme” this week was going to be No One Fights Alone!

 

Oncology Visit #10

On our way to VSEC with some new “bling!”

This week Margarita’s passed her physical exam with flying colors, and her CBC was normal (aside form the mild anemia that is continuously monitored).  Margarita’s chemotherapy this week is an oral medication that is administered by us at home.

This Week’s Treatment:

  • Cyclophosphamide 40mg
    • Give 2 tablets by mouth on 5/22, and 5/23 and 1 tablet by mouth on 5/24
      • Wear gloves
      • Do not split/crush tablets
    • This drug can cause some irritation to the bladder (called sterile hemorrhagic cystitis).  This week we will have to monitor Rita for straining during urination, urinating small amounts frequently, incontinence, or blood in her urine.

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This Week’s Treat

Margarita was excited to indulge in some grilled chicken nuggets and waffle fries from Chick-fil-A !

Grilled nuggets!!

Waffle fries!

Have a great week, everyone!

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

 

 

Losing is NOT an Option

Week 8 Recap and Oncology Visit # 9

You beat cancer by the way you live, why you live, and the manner in which you live.”  ~ Stuart Scott

 

Week 8 Recap

Overall, Margarita has been a complete trooper though her chemo treatments.  In fact, I was beginning to think that we were on Easy Street.  No complications…halfway through the 16 week protocol …we got this, right?! But then Sunday night rolled around, and I began to think otherwise.

Last week, Rita had her “off-week” which means she only had to visit the oncology office to get blood work. We assumed this would be one of her best weeks, as it had been when she had her last “off-week.”  However, this was not the case.  On Mother’s Day evening (May 12), we noticed a drastic change in Margarita’s overall spirits, appetite, and energy level.  She had no interest in coming out of her crate, in eating – or anything for that matter.  She would not leave her crate, and if she did, she would only go as far as the dog bed next to her crate.  Sunday night she didn’t eat her dinner, would not get up to go outside, and would not sleep in bed with us.

I must admit, all my positive-thinking strategies went out the window, I slipped into immediate panic-mode, and thought the worst:  The chemo is not working, the cancer is spreading, she’s not going to make it….

Monday morning she was still exhibiting the same symptoms.  She had her weekly oncology appointment scheduled for the next day, Tuesday, but we were afraid to wait that long.  We took Rita to her primary veterinarian, Dr. Campbell, Monday evening.  Blood work was drawn and resulted in some less-than-desirable levels.  Her CBC revealed a very low neutrophil count (~600-700) and more concerning, showed that Rita’s body was producing premature red blood cells. We learned that this could mean several things:

  • her anemia could have worsened
  • she has infection
  • her body could be rejecting the chemo, or
  • there could be a bone marrow issue.

As long as her symptoms did not worsen, Dr. Campbell said it would be safe to wait for our oncology appointment the next day.

Margarita remained lethargic and uninterested in food Monday night into Tuesday morning.  Needless to say I was very anxious to get to the oncology appointment Tuesday afternoon. Although I felt like I prepared myself at the onset of Rita’s diagnosis by planning for the worst while hoping for the best, I was anything BUT prepared to see our Sweet Reet feeling so awful.

Oncology Visit # 9:  May 14, 2019

I had texted my mom a picture of Rita before leaving for the oncology visit, and let her know about Rita’s decline.  My 6 year old nephew, James, (who is also one of Rita’s biggest fans!) was at my mom’s house at the time, and had asked how Rita was doing. My mom told him that she wasn’t feeling very well at the moment, and James took it upon himself to stop what he was doing and pray for our Sweet Reet.

Brian left work early to meet us at VSECDr. Risbon reviewed Rita’s CBC from yesterday, and suspected that Rita had a late neutrophil nadir.  (A late what?!) We learned that instead of Rita’s white blood cell count dropping at the usual 7-day mark after her Adriamycin treatment, it dropped later (around the 10-day mark) leading to her side effects of lethargy and decreased appetite. Dr. Risbon also explained that the premature blood cell production was most likely Rita’s body responding to her increased anemia (common in dogs without spleens going through chemo). PHEW!  As soon as I saw that Dr. Risbon was not bothered by this setback, my state of panic lessened.

Dr. Risbon did some additional blood work upon our arrival to VSEC. Rita’s neutrophils were already at 4400 which was a good sign.  Margarita was also gobbling down every treat the oncology nurse was offering – also a great sign!  Dr. Risbon explained that the drop (and the rise) in Rita’s CBC results could happen pretty quickly, and Rita had already rebounded from the drop.  Since Rita has not had a fever and her counts were improving, Dr. Risbon held off on administering antibiotics.  Dr. Risbon decided it was best to postpone this week’s chemo treatment for another couple of days, so we rescheduled treatment for later in the week.  Dr. Risbon also dispensed Cerenia for Rita to take over the next 4 days to help Rita maintain a healthy appetite.

Medication:

  • Cerenia (24 mg (each)
    • Give 2 tablets by mouth once a day (every 24 hours) for nausea

What we experienced this week taught me that setbacks are not only OK,  but something to be celebrated. Why the heck would we celebrate a setback?? Setbacks are unpleasant, but are a blessing in disguise . They are wake up calls to remind us not to get too comfortable or too confident. Setbacks force us to stop, regroup, question, and most importantly learn. Analyzing and digesting setbacks is only going to make us more knowledgeable – and knowledge is power…the power needed to help our girl take an even BIGGER bite out of Lymphoma, and to turn her setbacks in to COMEbacks!

It’s normal to be upset when you see a loved one feeling so badly, and I am the first to admit that I am THE Queen of Panic.  It’s easy to lose focus and freak-out, thinking about the worst case scenario.  I realize now how important it is to stay grounded – that even though there will be road blocks we encounter along the way, it is imperative that we focus MORE on the faith we have in the superior medical team of Dr. Campbell and Dr. Risbon and the amazing strength and resilience of our Sweet Reet…  and less on the fears that cancer so easily implants in our minds.

Setbacks are nothing but a teaching tool to make you stronger…This was a very slight delay – a temporary detour…and no where near the defeat I had thought we were facing…. no matter how big the setbacks may be, we will figure it out, because losing is NOT an option.

Nice try, Cancer.  Our game isn’t over yet – and Margarita is still kicking your BUTT!!

 

Oncology Visit #9, Take 2:  May 16, 2019

Back to VSEC we go! …This time with Rita feeling much better.  Rita was completely back to herself:  eating normally, playing in the yard, and the sparkle was back in those sweet eyes!

Rita was in much better spirits, and was very excited to see her favorite oncology nurse, Sherri, who always carries treats for Sweet Reet!

Margarita’s physical examination was normal, and she even gained a little bit of weight!  A new CBC taken at this visit was acceptable for continued chemotherapy.

This Week’s Treatment

  • This week Margarita received Vincristine intravenously.
    • We will have to watch the site for any inflammation, oozing, or discharge.

This Week’s TreatS

It’s only fair that when you have two oncology visits in one week, you get TWO cheat-days!

After Rita’s initial weekly oncology visit on May 14th, we stopped at Sonic Drive-In !

Rita had been eating the treats from her oncology nurse at VSEC, so we ordered her a plain hot dog in hopes that her appetite was continuing to  increase.

Hot dog for the win! We were thrilled that she was eating again!

Keeping with our Drive-In treat theme, following oncology visit #2 on May 16, Rita and I stopped at Weber’s Root Beer , a “true” drive-in where you pull up, put your lights on for service, and a server brings out your order on a 1950’s metal tray that hooks to your window!

Weber’s has been around since 1951!

Rita’s order was a pork roll and cheese sandwich (or Taylor Ham for you North Jersey folk!) and fries…and  I ordered a root beer for my self!

YUM! Lip-smackin’ good!

Taking a bite out of her first pork roll sandwich:

Margarita decided she was not in the mood for the fries, and was most interested in the pork roll itself, so I pulled pieces of the meat out of the sandwich for her to enjoy.

 

 

Thank you for joining Margarita in her journey to take a bite out Lymphoma.

 

 

Be Your Dog’s Hero: Chase Away Canine Cancer

Week 7 Recap and Oncology Visit #8

Margarita had a slightly rough time this past week, but she did get to spend some time outside enjoying the softness of our newly sodded yard.

The side effects of chemo usually show up 3-5 days after the treatment day.  Although we started her on anti-nausea medication on the day of her treatment as a preventative, by Sunday Margarita was very lethargic and was not interested at all in food. This continued for about 3 days.  However, she slowly began to find food enjoyable again, and ate well the rest of the week.

Oncology Visit # 8

This was Rita’s “off” week for treatments, which meant she only needed to get blood work and a physical exam done to make sure she was healthy enough to continue treatment.  Her CBC showed no abnormalities, and her nurse noted that Rita was a good girl during her visit!

This Week’s Treat:

This week we stopped at Arby’s !  Margarita enjoyed a few bites of a roast beef and cheese slider.

She also had a curly fry for the first time!

 

“Chase” Away Canine Cancer

Chase away Canine Cancer is a division of the National Canine Cancer Foundation, and is an organization that is near and dear to our hearts. Chase was a female black Labrador Retriever, who was an Elite division dock diving competitor.  Her PAWrent, Cera Reusser, discovered a lump under Chase’s chin while petting her. The lump turned out to be metastasized cancer, which spread from nasal carcinoma. Unfortunately, even after the best possible care from her oncologist , Chase lost her battle to cancer, and passed away three months shy of her seventh birthday. Chase’s steadfast devotion to her family and her courage throughout her battle earned her the title of hero.

Cera became Chase’s Hero

Driven by the loss of her beloved Chase, and determined to find a cure for this devastating disease, Cera Reusser committed herself to being a hero for Chase, and set out on a mission to do all she could to help others in this difficult battle.  Through fundraising and the start of Chase Away Canine Cancer, Cera’s efforts in conjunction with hundreds of volunteers and donations from across the USA & Canada have made a huge difference in the fight against canine cancer.

Chase Away Canine Cancer posts resources for people who have fur-kids battling cancer.    Click HERE to view the current posts.

Chase Away Canine Cancer also has a volunteer-run online store , which carries products such as the personalized reversible bandana Rita is wearing in this post.  Profits from the K9 Trading Company’s sale of Chase Away Canine Cancer merchandise go directly toward the Chase Away Canine Cancer Organization. A portion of all other merchandise on the site also goes to Chase Away Canine Cancer.

How can you be YOUR dog’s hero?

  • Take a few minutes to do a body check each month.
    • Choose a monthly date (Chase away Canine Cancer suggests the 14th since this was Chase’s birthday) and do a body check on this date each month. The National Canine Cancer Foundation has graphics you can print out or save to help guide you through your monthly checks:

  • Be sure to schedule and attend your dog’s routine veterinary appointments.  
    • Follow up with an additional exam outside of your routine appointments if you observe something suspicious
  • Keep notes on any growths or abnormal behavioral observations
    • This will help you track important information about your dog’s health, and also will be helpful if you need to share notes to your veterinarian or a specialist on quick notice

As you may have read in our very first post about how we found Margarita’s Lymphoma, we did not discover any lumps. Sometimes cancer does not show itself in the form of visible lumps bumps. So what do you look for?  The National Canine Cancer Foundation lists these top 10 early warning signs of Cancer:

  1. Abnormal swellings that persist or continue to grow
  2. Sores that do not heal
  3. weight loss
  4. loss of appetite
  5. bleeding or discharge from any body opening
  6. offensive odor
  7. difficulty eating or swallowing
  8. hesitation to exercise or loss of stamina
  9. persistent lameness or stiffness
  10. difficulty breathing, urinating, or defecation

 

Thank you for joining Margarita in her journey to take a bite out Lymphoma.

 

 

 

 

The Power of Positivity

Week 6 Recap, and Oncology Visit #7

“Think positive and positive things will happen.”

“Being negative only makes a difficult journey more difficult” …But finding the energy and strength to have and keep a positive attitude after hearing Margarita’s diagnosis was almost impossible for me. However, after some deep soul-searching, I realized that being negative would get Rita nowhere, and do her (or me) no good. Negativity and gloominess is not gong to cure her cancer. Spending whatever time we have with her crying and being sad isn’t going to make the rest of her life enjoyable either.  Thinking positively not only helps my mind stay strong – but more importantly that positive energy transfers to Rita, who needs it most!

I am a firm believer in “everything happens for a reason”  …the people you cross paths with, the dogs in your life, and the situations you find yourself in.  Sometimes I can’t always figure out what that reason is right away – and sometimes I may never know the reason.  Most times, I am ok with that.  I am convinced all experiences in our lives – good AND bad – teach us a lesson, and allow us to grow.  But when I feel that a loved one has been dealt a bad hand, I find myself asking, “WHY does this have to happen?!”   I wonder if sometimes we ARE the lesson – – the experience that helps someone else digest a negative circumstance, cope with their emotions, and find the positive in an unfortunate situation.  All that being said, it is not easy by any means for me to live by what I write here.  Watching Margarita’s strength, resilience, and positivity as she left her “past life” behind and started anew with our family – and now her Lymphoma journey – has really taught me valuable lessons, and made a profound impact on my attitude and mindset.

Lessons Learned from Margarita:

  • Don’t dwell on the past.
    • Margarita was neglected and abused in her past life before being found as a stray.  Rita didn’t fixate on her past, or hold a grudge toward humans.  Instead, she embraced her new life, and returned the love to us two-fold. I realized that fixating on the past – her diagnosis of Lymphoma – and what may or may not happen was doing no one any good. It was easy to hold a grudge, wondering why something like cancer would happen to such a sweet soul, but Rita has taught me it’s time to leave the past behind, and focus forward…focus on the positive.
  • Use an unfortunate experience to help others
    • Margarita didn’t let her past neglect and abuse dictate how she treats humans.  Despite how humans let her down in the past, she found a way to trust, and has been spreading happiness everywhere she goes . As a therapy dog, she brought joy and inspiration into the lives of many humans in need.  “You may be given a cactus, but you don’t have to sit on it.” Rita opened my eyes to find a positive – to discover a way to “turn things around” not only for myself – but for others.  My hope is that sharing Rita’s journey through this blog will help other PAWrents get themselves and their fur-kid through a difficult diagnosis, or an unpleasant experience.
  • Don’t let anyone or anything slow you down or break your spirit
    • With the right attitude, anything is possible! Margarita has not let her chemo treatments get her down! She hasn’t let cancer stop her from living life to the fullest.  Rita has been kicking cancer’s butt and taking names!  Yes, she’s had some tough days after chemo, but she has not stopped doing the things she loves.  After her diagnosis, I found myself feeling sorry for her and for our family – thinking Margarita would no longer be able to do agility, or volunteer as a therapy dog – that we would not be able to camp, travel, or do the things we loved doing as a pack.  Margarita’s “Bring it on!” attitude through chemo has been inspiring.  As I watch her continue to live life to the fullest, I realized with a positive outlook, nothing can stop you!  Margarita encouraged me to be hopeful in continuing the things we love to do, and to start planning some new adventures for Rita and our family.

This is Margarita just a few hours after a chemo treatment enjoying her time playing in the yard:

I think all humans can learn from our fur-kids. Dogs take joy in even the smallest things.  They are thankful for each meal they are given, and throw a party every time they see their friends and family members – even if it had only been 5 minutes.

Humans should be strive to live each day like a dog!

Week 6 Recap

Margarita had ANOTHER wonderful week!  Rita had absolutely no symptoms or side effects, and enjoyed her time outside.

We were supposed to camp in Maryland this past weekend to attend a dock diving competition hosted by Delmarva DockDogs.  However, on our Easter camping trip, we discovered several leaks coming from our RV’s hot water heater and dishwasher. After some investigation, it turned out that the dealer who winterized the camper did not do the job correctly.  Luckily, this meant they were going to foot the bill, but this still meant we had to cancel our plans.  This became even more upsetting to us when we saw what our Delmarva DockDogs family had done for our Sweet Reet!

We always mention how lucky we are to have an extended family because of our pups … Well, here’s just one of many examples of just how wonderful these individuals are. These are some of our best friends – our Delmarva DockDogs family members – raising money for canine cancer in the name of Margarita. What a thoughtful, generous, and amazing gesture.

Margarita has an army backing her.  What a truly blessed gal she is to have so many people, and so much positive energy behind her in her biggest fight!

Oncology Visit # 7

This visit was the last treatment of Round 2, which officially puts Margarita at the half-way mark on her CHOP based chemotherapy treatments!  She will have blood work only next week – and then begin Round 3 of the 4 cycles of treatments the following week.

Rita’s oncologist, Dr. Risbon, said the CBC recheck results were normal, and that she was happy with Rita’s physical exam as well.  There were no abnormalities, and Rita’s weight has remained stable.

Today’s Treament:

  • Adriamycin IV in right hind limb
    • We are to monitor the site for any inflammation, oozing, or discharge.
    • Margarita will be on Cerenia (24mg) for the next few days in order to prevent nausea from the treatment.

This is one of the tougher weeks, as the Adriamycin can cause some pretty significant side effects.

This Week’s Treat:

This week we stopped at Shake Shack!

Margarita perked RIGHT up when she realized it was treat-time!

Margarita enjoyed a little bit of a grilled cheese, and a couple of french fries.

Did you know Shake Shack has a couple of special treats on their menu just for dogs?!  They have a “Bag O’ Bones,” which is a bag of 5 ShackBurger dog biscuits made by NYC’s Bocce’s Bakery , and a “Pooch-ini,” which is a ShackBurger dog biscuit in vanilla custard.

Rita loved her dessert!

Thank you for joining Margarita in her journey to take a bite out Lymphoma.

There’s No Fear in Fierce

Week 5 recap and Oncology visit # 6

“And though she be but little, she is fierce.”  ~Shakespeare

Week 5 Recap

They say God gives the toughest battles to his strongest soldiers.  Our little Margarita is the sweetest soul, but she truly has proven to be a fierce little warrior! I am certain her strength and resilience is fueled by the daily encouragement and prayers received from family and friends, as well as the amazing medical care and advice from her oncologist, Dr. Risbon, and her primary veterinarian, Dr. Campbell. Margarita’s amazing support team is also what lessens our fear as her PAWrents, and provides us with the positive energy, strength, and courage needed to assist her through this challenging journey.  Our dogs are very sensitive to our mindset and moods.  Knowledge is power, and a positive attitude leads to positive outcomes…the more knowledgeable and positive we are, the better we can assist Margarita to continue to be a fierce warrior in her battle.

I must admit – this is easier said than done.  I don’t think my mind and heart will ever be completely cleared of the emotional upset of Rita’s cancer diagnosis, but I have vowed to make a conscious effort to shift my worry of what could go wrong – to focusing on what a what could go right. Attempting to clear my mind of upset and worry is no easy feat – but it does allow my brain to make more room for learning how I can help Margarita, rather than obsessing on the “what-if’s.”  A good friend of ours, whose dog also has been through a cancer journey, suggested I read The Dog Cancer Survival Guide.  This book has inspired me to write Rita’s Journey into the blog, and to plan the fun weekly “chemo day” experiences for Margarita.  Watching her enjoy those pleasant activities and treats helps maintain my positive outlook as well.  We would quickly lose direction on our path without our amazing team of friends, family, and doctors walking beside us through this journey.

This past week Margarita has been eating well, active, and in great spirits.  She had an amazing week!

During last week’s oncology visit, Margarita was cleared to go on our Easter camping trip.  We originally had a vacation planned that would have led us about 4 hours away from home.  Considering this was the first camping trip since Margarita began chemo, we were a little nervous.  Instead of canceling the trip completely, we booked a last-minute reservation at a campground about 45 minutes from us.  This way, we could still enjoy camping, but also remain in driving range of both Margarita’s primary vet at Old York Veterinary Hospital, as well as her oncologist at VSEC.

Margarita enjoyed hanging out around the campsite at Crystal Springs Wilderness Lodges and RV Resort :

Walking around the campground and taking in the views:

…And of course – napping in the RV!

Oncology Visit #6

Arriving at VSEC

This visit is Week #2 of the “3-weeks-on, 1-week-off” 16 week CHOP protocol.

Margarita is always such a good girl in the waiting room!

Waiting for the oncology nurse

The oncology nurse took Margarita back to first be examined by her oncologist, Dr. Risbon.

Waiting for Dr. Risbon

When Dr. Risbon returned to our room, she told me that she did a physical exam and blood test.  Dr. Risbon reported that there were no abnormalities with Margarita’s physical examination, and noted that Margarita even gained some weight back!  Her CBC revealed a normal white cell count, and in addition, her anemia has also improved!

Week 6’s Treatment:
  • Cyclophosphamide 40 mg
    • 2 tabs by mouth 4/24 and 4/25, then 1 tab by mouth on 4/26
      • Administered at home
      • Wear gloves when administering.  Do not split/crush tablets

Today Margarita was sent home with Cyclophosphamide  – an oral medication that we will administer ourselves over the next couple of days.   This drug is known to cause irritation to the bladder (called sterile hemorrhagic cystitis) in 10% of the patients receiving it.  We will have to monitor for Rita straining during urination, urinating small amounts frequently, incontinence, or blood in her urine.  If any of those side effects occur or any additional concerns arise, we are to call VSEC for further instruction from Dr. Risbon.  If you remember from her Week 2 Recap, Margarita has a good week following her Cyclophosphamide, so we are hopeful the upcoming days will also be uneventful for her in regard to side-effects.

 

This Week’s Treat:

Since I am on Spring Break this week, I made a very-early appointment so that we could enjoy the rest of the day doing something fun.  Considering that it was still so early when we finished Margarita’s appointment, I decided that a breakfast treat would be the best choice for us!

We stopped at Dunkin’ Donuts !

Margarita enjoyed part of a bacon/egg/cheese Wake-Up Wrap.

And who doesn’t like a little something sweet at breakfast?! Margarita also enjoyed a piece of an Old Fashioned donut!

I was inspired to incorporate a “Special Treat Day” on days Margarita has oncology visits after reading The Dog Cancer Survival Guide. The author suggests a “Cheat Day” because it is new and unexpected, which helps your dog’s mind stay optimistic and stimulated.  I like to include these fun trips on Margarita’s treatment days so she continues to associate car rides with positive and enjoyable experiences.

Life is not always a walk-in-the-park …so always take one when you have the opportunity!  

The weather was absolutely amazing, and we had the rest of the day to enjoy it, so we visited Tomlinson Park – a nearby recreation area that I must drive past about 4 or more times a week – but never had bothered to explore.  I’m sure glad we stopped – You can’t see the whole park from the road, and I had no idea the park was this beautiful!

It’s a shame that someone installed an electrical outlet over top of the “N!”

The walking path followed along a beautiful stream.

“Of all the paths you take in life, make sure a few of them are dirt.” ~John Muir

The best surprise of all was the lake at the far end of the park!

After we explored Tomlinson Park, we took a short walk down Main Street in Historic Medford.

We stopped at one of Margarita’s favorite places:  Pride Paws!

Pride Paws is a retail pet store located in the heart of historic Downtown Medford.  Pride Paws provides job training and transitional employment experience to individuals with developmental disabilities who could not independently succeed in a traditional work environment.  The participants in this program greet customers, track inventory, create a bi-weekly schedule, prepare payroll, make dog and cat related items such as blankets, toys and note cards…and (Margarita’s favorite reason for stopping in!!) ….bake their famous dog treats right in the store!

Margarita not only loves the treats here, but she adores the participants of the program, and all of the attention and love they give her during our visits.  One of the Pride Paws employees noticed that Margarita’s underbelly had been recently shaved, and asked what happened.  I explained that she had surgery, and is undergoing chemotherapy treatments.  I also told them that after each oncology appointment, I choose somewhere special to go, and today’s pick was Pride Paws to purchase a bag of their famous homemade treats!  They were so happy we decided to stop in, that they gave Margarita an additional bag of treats for free!

We hope that upcoming days bring Margarita another amazing week!

Thank you for joining Margarita in her journey to take a bite out Lymphoma.

Print credit: Ginger Oliphant. Purchasable on her Etsy account.

 

Too Blessed to be Stressed

Week 4 Recap and Oncology Visit #5

“Count your blessings, not your problems.” ~ Roy T. Bennett

Week 4 Recap

We have so many blessings in our lives, but our problems tend to cloud our eyes and our heart to all of the special people and moments we have to celebrate.  Even during life’s most difficult times,  we need to make sure we focus on the blessings in our life and celebrate every day.

We are blessed to have a loving, supportive, and understanding family, and a large network of amazing friends and extended family… all who support us in our wild adventures and our passion for 4-legged children.

This week we are grateful for a particular family member who was able to bless Margarita.  Reverend George Deutsch (pronounced “DOYTCH”) is my soon-to-be 90 year old dog-loving great uncle.  He is still saying mass and doing confessions! I called him when Rita was having an awful week and asked if he would be willing to bless our Sweet Reet.  Not only did he say yes, he insisted on driving an hour to meet us after he finished confessions last Saturday! Of course he also brought his beloved dog, Lady, with him! Lady and Rita were fast friends!

Rita loved Uncle George!

Uncle George blessing Rita:

Blessed with Holy Water:

We are also thankful this week to the special people we have met because of our dogs.  Some we see often, others we have never even met in person.  It amazes me how many truly wonderful people there are in this world, and it fills my heart with peace, joy, and hope to know that they not only support us, they also truly love our fur-kids as family too.  The messages, advice, and prayers we have received is what energizes us to press on, and stay strong to help Rita through her journey.  We have also received very thoughtful gifts for Margarita.  It was because of Margarita that we began volunteering for Pointer Rescue, Org , where we met Jackie, also a PRO volunteer. This week, Jackie sent Margarita a hand-made quilt to help comfort her during her treatments!

We have our pack to thank for our extended family members, and we are truly blessed to have every one of them in our lives.

Health-wise Margarita had a GREAT week.  She was in good sprits, ate well, and was more active than we’ve seen her in quite some time!  She did, of course, make sure she still set some time aside for porch-sittin’ with Limoncello.

 

Oncology Visit #5

This week Margarita was scheduled at VSEC to have an an ultrasound and more blood work to make sure she was able to handle the next treatment.

We received the awesome news that Margarita’s ultrasound looked normal!  We were also very happy to hear that she had rebounded from that super-low white blood cell count she had last week!  This meant she was also cleared to receive her next treatment.

Today Margarita received Vincristine intravenously.  Her oncology nurse said she was an absolute angel, and her oncologist, Dr. Risbon, said she is pleased with her progress so far! We have to monitor the sight for any inflammation, oozing, or discharge, but there are no restrictions for Rita, which means we can go on our annual Easter camping trip this coming weekend(YAY!!).

Last oncology visit we discussed adding supplements into Margarita’s diet.  After further discussion with Dr. Risbon about Margarita’s unique case, we are going to just stick with probiotics for now to help with Rita’s intestinal disease.  Dr. Risbon informed us that the other supplements we were going to add need to be carefully thought-out and planned around any Adriamycin treatments, as they are abundant in antioxidants.  Wait – Since when are antioxidants a bad thing, right??! Our thoughts exactly.  As we researched the answer to this and spoke to our primary Veterinarian, Dr. Campbell, we learned that when healthy cells are oxidized, it is a bad thing…which is why antioxidants are so good for you.  BUT…oxidizing cancer cells destroys them…so that’s a good thing…a bit confusing at first!  If you provide cancer cells that are in the process of being oxidized (destroyed) through the chemotherapy drug Adriamycin, with something that stops the oxidation process, the cancer cells get stronger again and continue to harm the body.  We will continue to discuss our options outside of chemotherapy that can help Margarita with both Dr. Risbon and Dr. Campbell, and will be prepared to adjust our plan if advised.

Margarita is lucky to now have TWO home-made quilts to snuggle with on the way home after her visit.

She took a well-deserved nap on the way home!

This week’s treat

Margarita had to fast for her ultrasound, so I took her to two places to make up for the “absolute torture” she had to endure before her appointment.

First, we stopped at Philly Pretzel Factory where Rita enjoyed (part of) a pretzel dog.  We saved the rest for another time so we didn’t “over do” it.

Next, we stopped at K-9 Kakes , a bakery just for dogs!

Dave the Baker greeted Margarita with some samples.

Margrarita had fun shopping and telling Dave the Baker which treats she wanted!

All the treats at this bakery are made on the premises by Dave the Baker, and decorated by his daughter.  Ingredients are all-natural and preservative-free, the coloring/dye is all natural, and the icing is made with sugar free yogurt!

Thanks, Dave!

Thank you for joining Margarita in her journey to take a bite out Lymphoma.

 

 

Awareness is Power

3rd Treatment Recap and Oncology Visit # 4 

Week Three’s treatment went just as Rita’s oncologist, Dr. Risbon, said it might – rough.  Not at first though.  The first couple of days Margarita ate well and was in good spirits.

At our last visit (Wednesday, April 3), Dr. Risbon warned that Margarita may have the worst week ahead of her in regard to her treatments so far.  She noted that the side effects of nausea, vomiting, loss of appetite, and/or diarrhea could begin in about three to five days after her treatment.  Right on cue, three days later – on Friday, Margarita was visibly not feeling well, and not interested in food.  We tried all of our normal “tricks”… canned dog food, cream cheese, Spam, rotisserie chicken, cheese, eggs, bread, bacon, sausage… but she wasn’t interested.

By Saturday morning, Margarita was moving very slowly. She had some diarrhea and had mucus in her stool.  We called our veterinarian, Dr. Campbell, on Saturday morning to give her an update.  She let us know that she could call in an appetite stimulant if she continued not to eat.  She also told us to try parmesan cheese sprinkled on the food. Dr. Campbell’s concern was making sure Margarita got back on schedule with eating her prescription diet so that her little system could absorb proteins correctly and assist in the healing process.

Luckily, by Saturday night Rita began to eat a little bit of rotisserie chicken – but nothing else.  With a little coaxing (and some parmesan cheese), Rita did eat some of her prescription food.  Dr. Campbell called us on Sunday afternoon (I’m telling you – “they don’t make ’em” like her anymore!!) to check on Rita, who had been enjoying some Sunday Morning porch-sittin’, and some afternoon sunbathing.

Monday was a decent day where Margarita ate some food, but still appeared to not be feeling well.

 

Oncology Visit #4

This week’s visit consisted of meeting with the Oncology nurse, and getting blood work drawn.

Margarita’s CBC revealed a significant neutropenia (the presence of abnormally few white blood cells in the blood, leading to increased susceptibility to infection). In order to prevent infection, Rita was started on an antibiotic:

  • SMZ-TMP:  480mg tablets.
    • 1.5 tablets to be given once a day until finished

Another CBC will be repeated prior to any further chemotherapy treatments.  Margarita is scheduled for a CBC and Ultrasound next week, followed by an appointment with our Oncologist, Dr. Risbon, for continued chemotherapy as long as next week’s test results are acceptable.

This week’s yummy treat was a vanilla soft-serve ice cream cone!

After Margarita enjoyed a few licks, I removed the ice cream and let her enjoy the cone.

Awareness is Power

The greater your awareness, the greater your power.

Awareness is also the greatest agent for change.  One in every three dogs will get cancer… One… In…three!  Now THAT’s something that needs to change. The more PAWrents know about the facts and preventative measures,  the better we will be able to protect our fur-kids and decrease their odds of getting cancer.

Did you know that Lymphoma is the most common blood cancer seen in dogs?

Be your dog’s eyes: Do a cancer check on your dog at least once a month.  Lumps and bumps can often be easily seen.  But sometimes – like in Margarita’s case – being on the lookout for unusual behaviors and reporting them to your veterinarian is just as important for an early diagnosis and better outcome for your fur-child.

Below are some tips on how to do a canine cancer check on your dog.

 

 

Be your dog’s ears and voice:  Speak up and share anything you can about a cancer that has directly affected your fur-kid.  Get people talking – LISTEN AND LEARN! The more stories that are shared, the more educated we become about cancer.  This will result in more awareness raised, more research, and a greater opportunity for us all to take a bite out of canine cancer.

 

Thank you for joining Margarita in her journey to take a bite out Lymphoma.

 

Fight Like a Girl

Second Treatment Recap and Oncology Visit # 3

Margarita’s collar “bling” is growing! She has 2 St. Francis medals, which she received as gifts, a guardian angel medal, and a “Fight Like a Girl” charm.

I am very pleased to say that the week following Margarita’s second treatment was quite uneventful.  Margarita did not have any side effects, and was much more like herself.  She enjoyed playing in the yard, and sunbathing on some of the warmer days this past week.

“Keep your face to the sun and you will never see the shadows.” ~ Helen Keller

Oncology Visit #3

Rita is extremely well-behaved while she is in the waiting room.

Margarita quickly fell in love with her oncology nurse (who gives Rita lots of treats!)

Rita tries to wait patiently while notes are taken!

Rita found out where the treats were stashed – front right pocket! Haha

Margarita’s CBC revealed a normal white cell count, her anemia has slightly improved, and her lymph nodes are normal.  Her oncologist, Dr Risbon, was pleased with her progress.

During this week’s treatment, Margarita received Adriamycin intravenously. We are to monitor the site for any inflammation, oozing, or discharge.

Dr. Risbon informed me that this week may be tough for Rita, as the side effects of this treatment may cause nausea, vomiting, loss of appetite, and/or diarrhea. We were sent home with:

  • Cerenia 24 mg
    • To be given (2 tablets) once a day for 5 days to prevent nausea/vomiting
  • Metronidazole 250 mg
    • to be given (1 tablet twice a day) at the first sign of loose stool/diarrhea

Margarita’s Prednisone dosage was also reduced to 5mg once a day for this week.

 

I discussed supplements with Dr. Risbon.  We will be slowly introducing the following supplements into Margarita’s diet:

  • Nupro Silver
  • CAS Options
    • an antioxidant and immune support supplement for dogs. It helps maintain a healthy immune system and contains a wide variety of antioxidants to reduce free radicals in the body.
  • Probiotics
  • Natural Source bee pollen

This treatment exhausted Margarita.

However, when I pulled up to the Popeye’s drive-through, she suddenly forgot about her chemo treatment!

WHAT chemo?!?! Bring on the chicken!

I removed the breading from the chicken and gave a few small bites to Rita as her treat.

Margarita will have her another oncology appointment next week.
Thank you for joining Margarita in her journey to take a bite out Lymphoma.

 

 

 

 

St. Francis, Please Protect Margarita

First Treatment Recap and Oncology Visit # 2

Since her first treatment last week, Margarita experienced some vomiting, which we knew was a possible side effect.  Zofran, an anti-nausea medication, was prescribed by our veterinarian for an as-needed basis.  After 2 doses, Rita stopped vomiting initially.  The vomiting continued off-and-on  for a few days.  Luckily this stopped  by March 23rd, a few days before her second treatment.

We also experienced something that was not included on the “what to expect” list. Three nights in a row Margarita released her bladder in the middle of the night while asleep.  She was not aware that she did this, and did not wake up or move when it happened.

Margarita’s appetite is still good – although she is eating very slowly.  We are thrilled that she is still eating all of her meals, as nutrition will be extremely important in helping Rita fight her best battle.

 

March 26, 2019:  Oncology Visit #2

Just in time for her 2nd treatment, Margarita received some extremely thoughtful and supportive gifts this week.

An admirer who is calling on all prayers to heal and protect our little girl sent her a personalized St. Francis of Assisi medal:

 

Our friend, Heather, over at OK Collars sent Margarita a collar! Handmade by Heather, this collar has lime green ribbons on it for Lymphoma Awareness.
Margarita wore her Lymphoma collar and her St. Francis of Assisi medal to her appointment today.

The appointment:
Our oncologist, Dr. Risbon, said Rita’s exam was overall normal, and Rita gained weight (0.2 kg / or about 0.44 lb).   A blood test taken, and Rita’s CBC was acceptable for continued therapy. However her tests showed her to be a bit more anemic today.
Dr. Risbon said the vomiting Rita experienced could be a side effect but she did not seem concerned. Dr. Risbon also did not seem to worried about the bladder issues Rita.  She told us that some of the treatments (including this week’s medication) can cause some irritation to the bladder (called sterile hemorrhagic cystitis).  This week especially, we will have to monitor Rita for straining during urination, urinating small amounts frequently, incontinence, or blood in her urine.

Margarita in the exam room at VSEC

 

Treatment #2:
This treatment will be administered by us at home over the next few days.
  • Cyclophosphamide 40 mg
    • 2 tabs by mouth 3/26 and 3/27, then 1 tab by mouth on 3/28
      • Wear gloves when administering.  Do not split/crush tablets
  • Prednisone
    • 10 mg once a day until next treatment

 

After her oncology visit, Margarita got her favorite treat at Starbuck’s… a Puppuccino !

Another thoughtful and handmade gift was presented to us just in time for the start of Rita’s 2nd treatment.  Brian came home from work with a handmade recovery blanket made by Jess – a wonderful woman who works with Brian!
The inside of this beautiful quilt is lined with super-soft material  – perfect for Rita to snuggle in after her treatments!
Rita wrapped in her recovery blanket after the start of her 2nd treatment.
Margarita will have her another oncology appointment next week.
Thank you for joining Margarita in her journey to take a bite out Lymphoma.

 

Chemotherapy: What to Expect

Approximately 10-20% of veterinary oncology patients experience side effect after chemotherapy including:

  • loss of appetite
  • vomiting
  • diarrhea (generally 3-5 days after therapy)
  • drop in white blood cell count (generally 7 days after therapy)

Most of the time these signs are mild and self-limiting and resolve with supportive care (bland diet, anti-nausea / anti-diarrheal medication) at home.  Less than 5% or patients require hospitalization after treatment.

Below are the instructions and possible side effects of steroids and chemotherapy that we received from our Oncologist, Dr. Risbon, at  VSEC.

Steroids

Prednisone may cause the following side effects:

  • excessive thirst
  • urination
  • panting
  • increased appetite

Other rare but possible side effects include:

  • loss of appetite
  • vomiting
  • diarrhea
  • dark/tarry or black stools

****If your dog experiences any of the above rare side effects, you should call your primary veterinarian or your oncologist immediately.

Other very important things to note:

  • Steroids cannot be given with non-steroidal anti-inflammaroty medications (NSAIDs) such as Rimadyl (Carprofen), aspirin, Deramaxx, Metacam, Piroxicam, and other drugs in this class.
  • Once started, steroids cannot be stopped suddenly as this can be detrimental to your dog.  You must speak with your primary veterinarian or your oncologist for appropriate instructions on weaning your dog from this medication.

Chemo therapy instructions

Do not give the chemo if your dog is not feeling well. For example: vomiting, diarrhea, very lethargic, not eating, etc. Contact your oncologist before you begin/continue oral medication to receive further instructions.

Handling instructions for chemo

Wear latex gloves while handling chemo drugs. Dispose of the gloves into a garbage bag, tie the bag, and wash your hands. If you come in contact with the chemo drugs wash your hands thoroughly. Children and pregnant or nursing mothers should not handle chemo. Keep chemo in an isolated place, out of the reach of children and animals, and away from where other medications or food are stored.

Waste

A small percentage of chemo may be excreted in the urine and stool for the first two days after treatment. If your dog has an accident in the home wear latex gloves and discard in a garbage bag. Clean the area thoroughly with a regular cleaner and try to cover or avoid carpeted areas for 48 hours after cleaning. For waste outside, you should try to avoid the area for 48 hours or spray the area with water. If you are walking your dog on public property, bring a bottle of water and soak the area.

Side Effects

Vomiting/nausea

If your dog is vomiting, it may be due to the side effects from the chemo therapy or the cancer itself. If you have anti-nausea medication, you should start it at the first sign of vomiting. If you do not have this medication call for a prescription. Most of these medications can be called into your local pharmacy. If your pet vomits shortly after this medication is given (for example less than 15 minutes), the medication may not have been absorbed. It may be necessary for your pet to receive an injectable anti-nausea medication. Do not give any over-the-counter medications until approved by your doctor.

  • If your dog vomits more than 3 to 4 times in a couple of hours or vomits after every meal, take up all food and water for at least four hours. It will help in emptying their stomach of any contents while reducing the catalyst to vomit.
  • If vomiting continues call your primary veterinarian, or your oncologist
  • If vomiting stops after four hours of fasting, offer small amounts of water. This will help determine if your pet can hold anything in the stomach without vomiting. If your pet does not want to drink water, consider trying alternate fluids, such as broths, Pedialyte, apple juice, etc. If vomiting continues, you should contact your primary veterinarian or your oncologist for further instructions.
  • After several hourly trials of offering water with no vomiting you can try to offer small amounts, enough for only a couple of bites, of bland food. For example baby food, chicken and rice, etc. every three hours. If there is no vomiting continue to offer food. Slowly increase the amount offered each time.

****If you notice any blood in the vomit, notify your oncologist or your primary veterinarian immediately.

Diarrhea/Constipation

If your dog has diarrhea, it may be due to certain G.I. cancers, chemotherapy given previously, the body’s malabsorption of fluids, suppressed immune system, diet, or intestinal motility changes, among other possibilities.

Temporarily switch from your dog’s normal diet to a bland diet of boiled rice/pasta/potatoes and boil chicken or boiled hamburger. Keep your dog hydrated and make sure that water is readily available.

  • Continue this diet until the diarrhea has stopped for at least two days. You will then slowly mix back in your dog’s normal diet with a bland diet.
  • If diarrhea continues for two days while on this diet please contact your oncologist or your primary veterinarian for further instructions. An anti-diarrheal medication may be prescribed, as well as fluid therapy and a chem/electrolyte panel.

For constipation, consider giving canned pumpkin or Metamucil. Be sure to call your primary veterinarian or your oncologist for the correct dosage of Metamucil for your dog. Your dog may need to be seen if there is no defecation within a period of 48 hours. Do not give any over-the-counter medications until approved by your oncologist or primary veterinarian.

****If you notice black/tarry stools or the presence of blood, notify your oncologist or your primary veterinarian immediately.

Anorexia/poor appetite

If your dog experience has a poor appetite, it may be due to nausea from the chemo, the cancer itself, picky tastes, a pre-existing poor appetite, chemo related scent changes, among other possibilities. Try introducing other food choices, such as

  • Baby food or canned dog/cat food
  • Different brand of food, boiled chicken or hamburger mixed in with regular diet, roasted chicken, steak, fish, or cooked eggs
  • Flavor stimulants such as pet gravy from pet stores, or low-sodium broth
  • Warm soft foods, or add warm water to dry foods. This can bring out the flavor and aroma
  • Cottage cheese or plain yogurt, alone or mixed in with the regular diet
  • Try hand feeding or syringe feeding. Put food into the blender if syringe feeding

If you have any anti-nausea medication start the medication since poor appetite could be due to nausea. If your dog does not eat beyond two days, or if you are concerned, contact your oncologist or your primary veterinarian for further instructions. Certain medications may be dispensed to stimulate the appetite.

Lethargy/weakness/fever

If your dog experiences lethargy, weakness, or fever it may be due to the chemotherapy given, the bodies adjustment to the new chemo drug in the system, the cancer, among other possibilities. Usually this only last for a few days. Your dog may not act like him/herself, may exhibit behaviors not noticed before, and may not be feeling well. In response to this you should keep an eye on your dog for these things and notify your oncologist and or primary veterinarian if it progresses for an extended time or if you are concerned.

In addition take your dog’s temperature rectally with a digital thermometer, and use Vaseline or KY jelly for lubrication. Normal temperature range for dogs is from 100.5° to 102.5°. A temperature above 103.5° should be reported to your oncologist and primary veterinarian.

The Sixteen-Week Plan: PAWsitive Vibes Only

March 19, 2019

Margarita is a very special and complex case considering she has significant liver and intestinal diseases.  This does not allow us to deviate from her special diet, and limits some of our options. After much discussion with our primary veterinarian, Dr. Campbell, (who I would trust with my own life – they just don’t make women/people/doctors like her anymore!!) we have decided that Rita’s best chance of survival is to undergo at least one round of chemotherapy – IF her compromised system can handle the complete round.

We met Margarita’s oncologist, Dr. Rebecca Risbon, at Veterinary Specialty and Emergency Center (VSEC).

Based on the tests, Dr. Risbon explained that Margarita has been diagnosed with Stage IV A Lymphoma. Since her bone marrow was not tested, we are unsure if the cancer is present in her bone marrow. Chemotherapy is suggested because of this.  The staging chart is below, with Rita’s stages in bold.

Stages:

  • Stage I:  Cancer involving one lymph node
  • Stage II: Cancer involving more than one lymph node but on one side of the diaphragm
  • Stage III: Generalized lymph node involvement
  • Stage IV:  Spleen or liver involvement, with or without the previous stages
  • Stage V:  Bone marrow involvement

Substages:

  • Substage A: Absence of clinical signs of illness
  • Substage B:  Presence of clinical signs of illness

The good news is that Rita has a couple of prognostic factors in her favor.

  • Her cancer is B Cell (T Cell is even more aggressive than B Cell)
  • She is not Stage V
  • She is Substage A
  • Her calcium is normal

Without further treatment beyond the Prednisone she was on, Rita’s survival time would be about 1-2 months.  If we began chemotherapy, Rita has a chance of surviving approximately 12-18 months.  There was no question that we were opting for the chemotherapy.

With Rita’s Stage of Lymphoma, research has determined that the best results have been achieved with protocols that combine the 4 most effective agents against lymphoma:  Vincristine, Cyclophosphamide, Doxorubicin (Adriamycin), and prednisone.  This is referred to as CHOP-based protocols).  In most cases, the CHOP-based protocol used on dogs with Stage IIIA or IVa Stage Lymphoma produces an 80-90% remission rate, an average disease-free interval (1st remission) of 9 months, a median survival rate of 12 months, and a 20-25% survival to 2 years.

Margarita’s chemotherapy plan is 16 weeks.  The hope is that her liver and intestinal issues are not going to hinder this plan’s completion.

She will be seen on a weekly basis so that she may be evaluated for improvement and toleration of the treatment itself.

Today Margarita received the following:

  • L-asparaginase @ 400IU/kg
  • Vincristine @0.5mg/m2 IV
  • Prednisone @ 2mg/kg PO/day until next week’s visit

Due to Margarita’s other health issues, Dr. Risbon recommended keeping Rita on the prescription GI diet.  She also recommended to add fish oil back into her diet.  Dr. Risbon told us that fish oil as a supplement has been shown to improve survival times slightly in dogs with Lymphoma.

I promised Rita that we would do something special each week right before or right after her treatments.

This week she got to enjoy a couple of McDonald’s fries!

(Don’t worry – she only had a couple!)

Margarita is scheduled for her second visit with Dr. Risbon next week.

Image result for cancer bites with a green ribbon

Thank you for joining Margarita in her journey to take a bite out Lymphoma.

How We Discovered Rita’s Lymphoma

One evening this past January, we went to bed not knowing we would wake up to what would lead us to later “accidentally” discover that our Margarita has Lymphoma.

January 7, 2019

In the middle of the night, on January 7th, Margarita jumped-up out of a sound sleep and hopped off our bed.  She went to the bedroom door and proceeded to urinate on the floor.  This was not like her at all.  We questioned ourselves – “Did we forget to let her out before bed?” We took her out into the yard, and watched her urinate several times… “Must be a urinary tract infection!” we said.  We also observed that she seemed a bit out of sorts, and just stared off in to the empty yard.  The next morning though, she seemed fine, and was not urinating more than normal, so we did not think a call to our veterinarian was necessary.  The next night, we were woken up once again by the sound of Rita frantically jumping up and running for the bedroom door.  This time, she defecated on the floor!  We didn’t know WHAT to think at this point.  You may be reading this thinking – “What’s the big deal?” – dogs have accidents, end of story.  NOT this dog, and NOT in the middle of the night.  Rita lives for her beauty rest.  Rita does not EVER get up in the middle of the night, other than to switch sleeping positions.  By the end of the night on Tuesday, January 8 and into the morning on Wednesday, January 9, Margarita again began to urinate very frequently – much like the symptoms of a urinary infection.  She also seemed lethargic, and less interested in food (DEFINITELY not like Rita at all).  Wednesday morning we called our veterinarian, Dr. Campbell, and made an appointment for that night.

January 9, 2019

I drove Margarita to the vet on Wednesday evening expecting for a quick appointment with Dr. Campbell telling me that Rita had a urinary tract infection.  A urinalysis was conducted at the visit – and Rita did, in fact, have blood in her urine, and was given Cephalexin.  Margarita’s gums were also very pale and tacky, and her temperature was low.  Margarita was screened for tick-borne diseases, and this was negative. When I began describing other some of the other unusual-for Margarita-behaviors, Dr. Campbell asked if I would be OK with her doing a quick ultrasound on Rita.

When Dr. Campbell returned to the exam room with Rita, I could tell by her face I was not going to like the news of her findings. What was seen on the ultrasound was what looked to be a mass on her spleen.  A full panel of bloodwork was done on Rita.

  • CBC / Blood Smear In-House
  • IDEXX Total Health

The bloodwork results showed that her liver values were elevated, and that she was anemic.  Dr. Campbell immediately referred us to get an ultrasound with a specialist at Veterinary Specialty and Emergency Center (VSEC).

During this time, I had elected to put Margarita on “temporary retirement” from visiting my school as the District Therapy Dog.  I had not given any of the details to the students, but I did tell them she was not feeling well.  One of my very thoughtful students brought in a gift for her.  Inside the bag was a bone and sweet get-well note.

Margarita enjoyed her treat when I went home for lunch that day.

January 10, 2019

Rita was seen for the ultrasound at VSEC on January 10th, where a full abdominal ultrasound was done by Dr. Ana Caceres.  A splenic mass measuring approximately 2.5 cm in diameter was seen, but Dr. Caceres felt like the mass was unlikely to be the primary cause of Rita’s symptoms.  Dr. Caceres recommended that we pursue further evaluation regarding her urinary tract.  The following test were done in addition to the ultrasound:

Dr. Caceres referred to see an Internal Medicine doctor.

 

January 12, 2019

Dr. Campbell, our primary vet, did chest x-rays on Rita, which thankfully came back clear.

January 16, 2019

Margarita saw the head of the Internal Medicine Department at VSEC, Dr. Alan Klag. Dr. Klag did an exam and ran some blood work and took a sterile urine sample.  Although a recent urine culture taken at our primary veterinarian’s office was positive for Staphylococcus pseudintermedius, Dr. Klag did not expect that to cause the current clinical signs unless the infection was in her kidneys – but even then he would not expect the anemia, hypoalbuminemia, and increased  ALT that were present in her bloodwork.   Dr. Klag ran the following tests:

  • PCV/TS
  • Mini Liver Panel

Dr. Klag decided to treat the urinary tract infection with Enrofloxacin .  Dr. Klag suggested that considering the other symptoms we are observing, Rita could be experiencing some small repeated bleeding incidents from her splenic mass. It was suggested that we consult with a surgeon to discuss the biopsy of the splenic mass and/or a possible splenectomy.

January 25, 2019

Margarita had some more blood work done with Dr. Campbell to re-check her liver levels.

  • IDEXX Catalyst Chem 10 CLIP
  • PCV (Packed Cell Volume) / TS
  • IDEXX CBC, Comprehensive

January 30, 2019

We were still observing a bloody discharge from Rita’s rear-end.  Because of this, several stool samples were sent out to Texas for a Fecal Alpha Proteinase Inhibitor test .  The concern was that Rita had a GI disease where proteins could be lost into the gastrointestinal lumen.  Gastrointestinal protein loss can be associated with a variety of gastrointestinal and systemic disorders such as:

  • idiopathic inflammatory gastroenteropathies
  • gastrointestinal neoplasia
  • foreign bodies
  • intussusceptions
  • small intestinal bacterial overgrowth (SIBO)
  • infectious enteritis
  • immune-mediated diseases
  • intestinal lymphangiectasia.

Margarita’s fecal tests came back negative.

February 14, 2019

Margarita was still exhibiting the same symptoms, and saw the surgeon on February 14th.  We met with Dr. Jennifer MacLeod to discuss Margarita’s case.  Dr. MacLeod felt that it was unlikely that the splenic mass was malignant. However, both benign and malignant splenic masses can appear identical on ultrasound, x-rays and even during surgery.  The only way to accurately diagnose the type of mass is with a biopsy.

Dr. MacLeod also felt as though there was a low chance of the mass rupturing, but because this can be very unpredictable, it should still be considered a risk. Both benign and malignant masses can rupture and bleed into the abdomen, which is a life-threatening condition that requires emergency surgery.

Margarita’s lethargy was still a bit of a mystery.  Dr. MacLeod felt that a liver biopsy may provide a cause for her increased liver enzymes, which could be related to her lethargy.

Due to the clinical changes and the splenic mass, Dr. MacLeod recommended exploratory surgery to remove the spleen, and do biopsies of Rita’s liver, and intestines in order to obtain a more definitive diagnosis.

February 21, 2019

Margarita had her surgery and biopsies.

The day Margarita went to the hospital for her surgery, a friend of ours sent her a Get-Well-Soon package from Chewy.com!

I could not believe this HUGE package of goodies for Rita!

Margarita had to stay the night at VSEC for monitoring, and was able to come home the next day.

February 22, 2019

On her way home from surgery:

Settling in at home after surgery:

Margarita had some difficulties the first few days, but overall, recovered well, and in about 2 weeks seemed more like herself again.

We set up a special “recovery room” so that our other fur-kids would not bother Rita while she was healing.

During her recovery she received gifts, flowers, and well wishes from so many people!

We were overwhelmed with the support, concern, and love our baby received.

Margarita with her card and gift from our neighbor:

Margarita’s “main-man” Mr. Spock the English Pointer sent her a beautiful bouquet of flowers:

 

February 27, 2019

On the morning of February 27th, we received the news that no one ever wants to hear.. there were malignant cells found in Rita’s spleen.  They were round cells, which indicated a type of Lymphoma. Additional tests would have to be run on the biopsies to identify what kind of Lymphoma it was.  But that wasn’t all.

Although malignant cells were not found in Margarita’s liver and intestines, she also had concerning diseases in both.  Her liver showed inflammation patterns that represented chronic hepatitis.  Despite her prior negative Fecal Alpha Proteinase Inhibitor test, her intestinal biopsy showed a severe degree of inflammatory bowel disease, causing the loss of proteins.  Without these two significant issues under control, Margarita would not be able to handle cancer treatment, if needed. Margarita was put on steroids, and her diet was changed to a GI-specific diet. The symptoms we had been seeing in Rita were not necessarily from the cancer itself – so we were very lucky in a way to have discovered ALL of this before it was too late.

We ordered the additional immunohistochemistry, for all previous biopsies, and anxiously awaited the results.

March 13, 2019

The detailed results and diagnosis came back to us in the afternoon on March 13th.  It was then that we found out Rita has Diffuse Large B Cell Lymphoma. We also learned her lymph node, liver, and intestinal biopsies thankfully did not show signs of the cancer spreading at this time to those areas specifically.  Unfortunately, even after malignant tissue is removed, the cancer may have already spread microscopically to other areas.  Since the cancer was detected in the spleen, which filters the blood, there is a concern that the cancer could now be present in her blood and bone marrow.

Dr. Campbell referred us to see the oncologist at VSEC.