On 10/15/20 and 10/18/20, Margarita and I completed the Paws for the Law 5k – a special “Thank You!” to Law Enforcement Officers everywhere.
Police Officers wear ballistic vests as part of their daily uniform, however, the K-9s who are putting themselves between officers and an armed suspects are often not provided the same protection. 100% of the funds raised from this event were used to purchase:
K-9 ballistic vests that provide protection against guns and knives for K-9s who are used to help track and apprehend armed suspects
Opioid reversal kits for narcotics K-9s who may be exposed to inhaled or ingest drugs.
The charity that hosted this event was The Delisle K-9 Officer Safety Foundation. The DeLisle K-9 Officer Safety Foundation began raising funds for K-9 Officer ballistic vests in the fall of 2016 after hearing of a K-9 shot and killed in the line of duty. These vests cost an average of $1,200 each and are usually not included in police department budgets. Since that time they have become a 501(c)3 and have raised enough funds to purchase 31 bulletproof K-9 vests, helping to protect K-9’s throughout Delaware and across the country. Each vest purchased helps to protect the K-9, which in turn protects our dedicated Police Officers!
On Sunday, September 13, 2020, Margarita completed the Dogs Run 5K .
We walked this one through the historic town of Medford, NJ, taking our time and stopping at many historic landmarks in the town.
This race wound up being set up by a fraudulent organization, so we never received our medals – I did get my money back – but despite the disappointment of the fraud, this was truly one of my favorite walks with Sweet Reet.
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:
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.
This month Rita continued to increase her activity and has been more vibrant than ever!
Rita enjoyed the homemade Agility course in our yard:
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.
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.
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.
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
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!
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
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.
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.
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!
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.
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!
Never, EVER give up!
Research and explore all doable options
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
Double Digit Birthday!
Click HERE to see the post of her birthday activities
One year since the detailed results came back that told us:
the type of Lymphoma Rita had (Diffuse Large B Cell Lymphoma)
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
GGTNormal range: 0-13
Rita’s GGT value: 22
ASTNormal range: 16-55
Rita’s AST value: 146
ALPNormal 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
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:
GGT Normal Range: 0-13
Rita’s GGT Values:
AST Normal Range: 16-55
Rita’s AST Values:
ALP Normal Range: 6-160
Rita’s ALP Values:
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.
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!
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.
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.
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.
No abnormalities were found during Rita’s ultrasound.
Margarita’s white blood cell count was a bit low, so she was placed on an antibiotic as a preventative.
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.
“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’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.”
“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!
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…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.
“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.
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!
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
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.
“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:
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.
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.
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:
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
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
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.
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:
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
“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.”
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:
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
Also recommended to our by a friend of ours whose dog also battled cancer
Join a Facebook support group such as the examples below or search for groups on Facebook specific to your dog’s needs:
Note: Not all Support Groups have the same goal. Some groups provide support and comfort, and others are focus on the technical side of handling canine cancer. You may want to consider joining more than one group to explore which ones suit your needs best.
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.
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 CorgiAid, Special Needs Dobermans, LabMed, Pit Bull Rescue Central.
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!
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:
Give 2 tablets by mouth on 5/22, and 5/23 and 1 tablet by mouth on 5/24
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.
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 VSEC. Dr. 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.
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.
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:
Abnormal swellings that persist or continue to grow
Sores that do not heal
loss of appetite
bleeding or discharge from any body opening
difficulty eating or swallowing
hesitation to exercise or loss of stamina
persistent lameness or stiffness
difficulty breathing, urinating, or defecation
Thank you for joining Margarita in her journey to take a bite out Lymphoma.
“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.