Complete Peripheral Remission

Burke waits for me at the clinic while I pay the bill

Burke is in "complete peripheral remission!"

The ride went better today.  We used 150 mgs of Trazadone and I drove Paul's BMW.  Burke is more comfortable in the backseat of the BMW than my Honda.

He was given his treatment and then Dr. Hamilton said "Burke's in remission!"  Wow - that's amazing. We have so many more treatments in front of us but I am so happy that he is responding to the treatments so quickly.

We are also further cutting down on the prednisone - 1/4 tablet every other day by mouth for a final 4 doses. That should help with the panting.

Burke was pretty loopy tonight.  Paul is going with me to Malvern on Wednesday and we leave for Maine on Friday.  Let's get this puppy to the beach!

a little loopy

More Energy and diarrhea

Morning Walk 6.28.15

Burke was ready for his morning walk and actually whined for an evening walk - literally sat next to the front door and whined!  He was alert most of the day and went crazy when my son came over for a visit - crying, jumping, kissing/licking, barking - it was wonderful to see him so excited!

His appetite is still strong but I think I introduced his new diet to quickly. I thought I was adding it gradually but this afternoon he had diarrhea (which may also explain the whining at the door for a walk). I want to get the good food into him, but I will offer less with his kibbles tomorrow.

Burke is also panting again and it's not hot and it's not after exercise.  He wasn't panting yesterday but today again he is panting, and I don't like it. His respiration rate is 60/minute while he's sleeping.  When he was first seen in the emergency veterinarian hospital he had pleural effusion and an enlarged thymus.  The ER vet drained some fluid off of his lungs and he had been breathing better.  Now he's panting again and I am concerned. We will be back at the oncologist's office tomorrow and I will bring this up with Dr. Hamilton.

I am again dreading the drive with Burke.  I will give him more of the sedative and hope the trip goes better. If you're reading this blog and live close to me (Harrisburg, PA), I could use your help in taking Burke to the oncologist's office this week.  He's so much better when I ride in the back seat with him.

Anti-cancer Diet

Someone needs to have their ears trimmed.

While Dr. Hamilton asked me to hold off on supplements for a month, he made no limitations on the food I feed Burke.  "Chicken, liver, tuna, whatever he enjoys." So I have been surfing the internet looking for diets that help to fight cancer, or at least do not promote cancer.  One diet I found encourages protein (chicken, beef, pork, lamb, etc.,), certain fats, complex carbohydrates such as oatmeal or brown rice, vegetables, and calcium.  It's called the Dog Cancer Diet. (I am gently simmering chicken and steel cut oats as I type this blog.)

We will gradually make the transition to this diet over the next week.  I am sure Burke will enjoy this new "dog" food. With the exception of the krill and fish oil, I already regularly add these treats to his meals. 

It has been raining (again) all day.  Burke played with us a bit and sat outside with me while I spoke on the phone to my daughter. Other than that, he has been mostly sleeping -- it is a good day for sleeping.  

I stopped the anti-nausea medication because Burke shows no signs of nausea.   We are still on the prednisone and on Monday we go back to Malvern for a chemo and antibody treatment. I can still feel Burke's enlarged lymph node, but, to me it seems smaller.  I hope Dr. Hamilton agrees. 

Sweet Potatoes and ready for my morning walk!

Ready for my morning walk.

I forgot about sweet potatoes!  I have been giving Burke rice but someone from the Flatcoat Retriever Health Support Group suggested pumpkin for his diarrhea.  Burke doesn't like pumpkin but he loves sweet potatoes.  So last night and this morning he had sweet potatoes with his boiled chicken and organic chicken broth and it is beginning to help!

Burke had some more energy this morning.  We worked for about 5 minutes on some obedience and then I asked him if he wanted to go for a walk.  He went immediately to the door.

We had his best walk in over 2 weeks!  He pranced his flatcoat prance most of the way, made eye contact with me regularly - I think he was wondering why I was letting him run out his leash the whole time, and did not break into a heavy pant.  I even jog along with him for a few feet in the soccer field where we usually get our exercise.

Now he is sleeping at my feet.  I am going to call the oncologist today to see if I can discontinue the anti-nausea medication because Burke has a vigorous appetite and no signs of nausea.

Today I am feeling thankful that Burke is feeling better and that so many people care about Burke and our fight.

Selfie with Burke

Car sickness, Diarrhea & Lethargy

Our very first (of many) pictures of Burke

Not the best title for a post but it sums up what's going on quite well.  

Burke REALLY does not like car rides.

Burke is a very sensitive dog.  He has always been a very sensitive dog.  He backs away from situations that frighten him (so do I). When he was a pup and we took him to obedience class, he panted and drooled in his crate on the way to class. When we got to wherever we were going, his little paws would be soaked with drool.  My trainer helped me work with him and brought over her flatcoats to teach Burke that "riding in the car is fun!"  That training did help with getting Burke into the car, but it never helped with his obvious anxiety.  Sometimes he was so upset he would vomit.  So I learned not to feed him within two hours of any car ride.

I told Dr. Hamilton about Burke's condition and he prescribed 100 milligrams of Trazodone. The dose I gave him yesterday along with using his favorite bedding, D.A.P. spray, and "relaxing music for dogs" was insufficient for our trip to Malvern.  Dr. Hamilton said I could increase the dosage to 150 milligrams. I hope that helps because I am so distressed by Burke's anxiety.  I know that stress suppresses the immune system and that is the last thing we need right now.  

I also told Dr. Hamilton that Burke had vomited three times within the first 12 hours after his antibody and chemo therapies but that he had not vomited since.  Dr. Hamilton said typically if a dog is nauseated by the chemo, it does not go away after one dose of anti-nausea medication.  He suspects the nausea was caused by stress - yeah, ya think!

Burke's lethargy continues and this morning he had diarreah.  I introduced probiotics into his breakfast before he had the diarrhea - was that a mistake?  I will add a little extra rice into his next meal.

So glad we don't have to go anywhere for the next 4 days. 

Our unhappy pup

On the road again...

Our first (and only) show experience - holding on to my fidgeting puppy

Today we head back to Malvern, PA for Burke's second antibody treatment.  I will give him the prescribed anti-anxiety medication an hour before we leave and hopefully the car ride will go better for him.

Burke seemed to sleep more comfortably last night.  His dosage of prednisone has been cut in half.  I read that the prednisone can make dogs feel hot, so maybe that explains his willingness to sleep with us in bed and snuggle a bit more.  He is still very lethargic but retains his appetite.  He mostly sleeps at (on) my feet while I work at the computer.  His breathing is quiet and his respiration is normal. We continue to take short walks around the neighborhood in the morning or evening when it is cool which he enjoys. I watch him carefully and when he starts to pant or drag a bit we head back home. This morning on our walk he started rolling around in the dew covered grass, much like he rolls in the snow or leaves or anything else that takes his fancy.  I hope he is feeling well when we go to Maine next week.  He will have the sand and the sea to explore -- we planned this vacation around Burke before he was diagnosed with lymphoma.

I am VERY glad that Burke is now holding down his food and doesn't have diarrhea.  This gives me hope that he will respond well to his treatments.

Bully for Burke!

Burke had a tough night last night.  He got up twice and was sick to his stomach. His energy is very low. Fortunately, he still has an appetite. 

We started off today with the anti-nausea medication. Afterwards I gave him some rice mixed with boiled chicken and organic chicken broth which he thoroughly enjoyed (while his buddy Fez the cat looked on with jealousy). 

The extreme lethargy has returned. Both Paul and I are feeling very low with Burke feeling so poorly. His energy had returned to him from the prednisone and now we are back to worse than where we started. I hope we are doing the right thing. We will take it a day at a time. Tomorrow I go back to the cancer clinic for his second antibody therapy. I will discuss Burke's nausea with the doctor at that time. Maybe the dose I gave him this morning will help him.

Bully for Burke!

update from this morning...

Burke woke up from his morning nap and I offered him a bully stick.  Typical for Burke, he promptly took it outside, buried it my garden and then came back inside the house. Less than 5 minutes later he was whining at the door.  Out he went, dug up his bully stick, chomped away on it for a bit, and re-buried it.  So, I guess he's feeling better after his nap.  No nausea either.  Fingers are crossed.

Flowers Burked "picked" for me.

Other than Burke's short rally with the Bully stick this morning, he has been very lethargic all day.  I have been feeding him small meals every two hours and he has not gotten sick. I am thankful that the anti-nausea medication seems to be working.

First Chemotherapy & Antibody Therapy Treatments

Wet flatcoat = happy flatcoat
Taken 6.21.15

Today we drove an hour and half back to the VRC Cancer Center in Malvern, Pennsylvania. Paul had to go to work so I drove solo with Burke panting in the backseat. Burke has never been a fan of the car - I will ask the vet about a medication for travel anxiety since we will be taking this trip - a lot!  I should probably get some meds for myself too.

We arrived at the hospital slightly before 11:00am and found the waiting room full of pets and their owners: two golden retrievers, a boxer, and a little white fluffy dog. We were taken back to an examination room immediately and met with Dr. Hamilton.  I had a list of questions that we went over. 

What is Burke's life expectancy with chemo alone? 6 months on average for dogs with t-cell lymphoma. 

What is Burke's life expectancy with chemo plus the new antibody therapy? Since the drug is so new there are limited studies, but on average it will extend his life by 40%. These are just averages and some dogs live longer (which means some dogs live shorter).

How long will the Burke be in treatment? Chemotherapy will be given by IV once a week for the first 8 treatments followed by a final 8 treatments given every other week. Antibody therapy (also given by IV) is twice a week for the first 4 weeks followed by a final 4 treatments given every other week.

How long before we know if it's working? He should be in complete remission in 1 month's time.

How will you know if it comes back?  We will evaluate him monthly.

What about supplements?  How do you feel about turmeric paste? I neither encourage or discourage supplements because there is no scientific evidence supporting or dispelling the efficacy of these alternative treatments.  I wish there were. I would prefer if you held off during his first month of treatment before introducing supplements so that we can determine his reaction to the chemotherapy and antibody therapy. I do not want Burke to have any adverse side effects from the treatment and if he does have any adverse side effects I want to know what's causing it. 

We planned a vacation to Maine in over the 4th of July. Can Burke get these treatment in Maine? Yes, there is a canine oncologist in Portland, Maine that can give Burke his treatments. I've already been in touch with him. (I really like you Dr. Hamilton!)

How much will the treatment cost? The chemotherapy will cost $6000 and the antibody therapy will cost another $6000.

(wow)

As I write this blog I am thinking that some will judge me for spending so much money on my dog in order that he might live another year or two - I understand.  Before I had this dog, I would have judged me too.  There are always other/better uses for our money, but we have decided to do this.  If you feel differently, please don't comment here because this blog is about supporting Burke in his fight against cancer.  Burke will be part of a study for antibody treatment and Burke may win -- we are betting on Burke.

So Burke got his treatments and an anti-nausea medication and an anti-anxiety medication.  I was also told to cut his prednisone in half.

later on...

Burke was slightly sedated for the therapy so he laid quietly in the car on the way home.  I offered him his meds and water when we got home and some food.  He drank quite a bit, ate his meal and fell asleep.  After about 2 hours he woke up and got sick -- I probably should not have fed him.  I don't know!  Paul came home from work and Burke was very happy to see him.  After a cheerful greeting, Burke laid down again and fell asleep.  

I am feeling very ambivalent and sad.  

Breen Labs

Burke's Rule: If someone shaves your belly you get a rawhide - period!

It's Friday.  One week ago today we took Burke to our local vet because he was lethargic. On Monday Burke was seen in the VRC Emergency Clinic in Malvern, Pennsylvania and given his initial diagnosis of lymphoma.  On Tuesday we met with the oncologist.  On Thursday we received the pathology report: t-cell lymphoma. Not a good week.

One bright spot in all of this is the incredible support we have received from our breeder, the Cancer Support Team of the Flatcoated Retriever Society of America, and two Facebook groups: Flatcoated Retrievers and Flatcoated Retrievers Health Support.  

Another "positive" is Breen Lab at North Carolina State University's College of Veterinary Medicine.  Drs. Breen and others are conducting studies "focused on exploring the cellular genomics of canine cancers and the investigation of any evolutionarily related genetic aetiology shared with human."  Through the FCRSA Cancer Support Team I was able to learn about Dr. Breen's work and arrange to have samples from Burke sent to North Carolina.  My breeder is also sending samples from her dogs.  Your help is needed - PLEASE won't you send blood samples from your healthy senior flatcoated retrievers to Breen Labs.  It's easy.  Instructions can be found on the FCRSA website. 

If you are interested in making a tax deductible donation to support this research please consider visiting the North Carolina Veterinary Medical Foundation (mention the "Cancer Genomics Fund").  You can also donate to the Flatcoated Retriever Foundation which helps to fund various cancer studies including Dr. Breen's study on lymphoma.

T-Cell lymphoma

Enjoying the backyard 6.18.15

Dr. Hamilton emailed me tonight. Burke has t-cell lymphoma.  We start CD-52 Antibody therapy on Monday.

First Visit to the Oncologist

Do we have to go?

We took Burke to meet with Dr. Hamilton at the VRC Cancer Center on Tuesday, June 16th. He examined Burke and expressed cautious optimism regarding Burke’s prognosis and the ability of the chemotherapy to put the cancer in remission.  

We were relieved to know that we had a choice other than palliative care. The goal, Dr. Hamilton said, is to return Burke to full health and to do so without distress. YES!  We want that! It turns out that chemotherapy in dogs tends to be well tolerated and adverse reactions to the chemotherapy doses used in veterinary medicine are estimated to occur in 10-15% of pets.  Okay, that sounds good too!

The type of lymphoma Burke has will determine his treatment plan (and life expectancy).  The results from the Colorado State University Veterinary Diagnostic Lab are expected today or tomorrow.  Burke's first chemotherapy treatment is Monday.  In the meantime, Dr. Hamilton started Burke on prednisone.  

We started our day in despair and left the clinic with hope. Hope that our boy Burke can, as my daughter said, "Kick cancer's butt!" We are hoping for a complete remission and are anxious to start his chemotherapy treatments on Monday, June 22nd.  

What type of lymphoma does Burke have?  What is his life expectancy?  Will he tolerate the chemotherapy?  Will the cancer respond to the treatment? How long will he stay in remission? Maybe he won't even have lymphoma -- we won't really know until the lab results come in from CSU, right?

I can't work.  I have trouble sleeping.  The only thing I can do well is read about lymphoma and post and read updates on the Flatcoated Retrievers & Flatcoated Retrievers Health Support Facebook pages. Burke is with me.  Sleeping quietly on the cool floor.  He wakes and licks his bare belly.  His wheezing is gone after 3 doses of prednisone.  For those who love their dogs, really love their dogs, you know our hearts are heavy.  

We welcome your prayer, well wishes, and kind words of encouragement.  We feel surrounded by the love of friends, family, and strangers.  Thank you for caring about us and Burke's fight against lymphoma.

Kick cancer's butt!

Burke has lymphoma!?

Burke

This is Burke, our 2 year old flat-coated retriever! 

Tragically, Burke has just been diagnosed with Stage V, t-cell lymphoma, a rapidly spreading cancer that is rare in such a young dog.  

Less than three weeks ago we noticed that Burke was acting lethargic - an unusual condition in a 2 year old flat-coat! Initially, we thought the fatigue was due to the heat - it has been very hot and humid in central Pennsylvania but when the weather became milder, he did not improve.  

We took him to the vet on Friday, June 12th and blood work was ordered. Over the weekend his lethargy increased as well as his respiration. He started to make a wheezing noise when laying on his side and I noticed that the left lymph node on his shoulder was swollen. We knew that something was very wrong with our puppy. We were back at the vets on Monday, June 15th. His blood work was normal but x-rays revealed fluid on his lungs and an obstruction in his chest! Our vet sent us immediately to the VRC emergency clinic in Malvern, PA.  The emergency room veterinarian took a sample from the fluid in his lungs and an ultrasound was performed while we anxiously waited.  

The veterinarian called us back to an examination room.  "Is there any possibility Burke has eaten rat poisoning?"  NO!  "Has he experience any trauma to his chest?"  NO!  

"Burke has pleural effusion and we don't know what's causing it. I took a sample of the fluid in his lungs and it's tinged with blood. Usually we see this when a dog has experienced trauma or has been poisoned.  We'd like to do an ultrasound."  

"What else might be causing this?" we asked. The veterinarian told us it could be caused by lymphoma, but they wouldn't know until the ultra sound was completed.  

Lymphoma?!  Cancer?!  I started to cry and so did my husband. We went outside and waited, not wanting others in the waiting room to have to deal with our obvious grief.  Within minutes they had the results.  "Burke has an enlarged thymus and enlarged lymph nodes throughout his abdomen."  "It's cancer!" I cried and my husband reached out a hand to calm me. "Yes," she said, "I'm sorry."  

My two year old dog is filled with cancer?  How can this be?  He came to us from a responsible breeder.  Both his lines have longevity.  He's too young for lymphoma!  My dad died from lymphoma!  

"Lymphoma does usually occurs in older dogs," she said." 

Cancer follows no rules.

I called my breeder, I called my trainer, I texted the news to my daughter and son and sister and Burke was returned to us  -- belly shaved but jubilant, jumping for joy and kisses and whining with happiness.  "Holly crap, mom and dad, what was that about?"

We were to return the next day and meet with the oncologist.

We took Burke home and drove most of the two hours in silence and tears.  We slept with Burke between us on Monday night -- a fitful sleep with Burke jumping on and off the bed and breathing heavy.  We didn't know what we were going to do -- either palliative care or chemo, those were our options.  We would decide tomorrow when we met with the oncologist.