As veterinarians, we are often asked by clients struggling to make a decision regarding their pets care “What would you do if this was your pet?” This is a fair question – after all, not only are we veterinarians, we are pet owners and lovers as well. We know what it is like to have four legged family members who integrate themselves completely and inextricably into the fabric of our daily life. This is not to say that what we would do for our pet is always going to be the best course of action for you and your pet – there are so many other factors that come into play – but sometimes we might be able to offer a somewhat unique perspective based both on clinical and personal experience.
Because of this, we have decided to share a very personal story. As many clients know, our (Dr. Gary Palmer and Dr. Robin Lewis-Palmer) dog is Piper – a six year old half Australian Shepherd half Standard Poodle (an Aussiedoodle!). Pictures of her populate our waiting room, our website, our Facebook Page and Twitter. She is funny, affectionate and lovable – like living with an overgrown muppet or Sesame Street character – and she is very much a part of our family.
Several weeks ago, we started to notice some subtle changes in Piper. She seemed to lose interest in her breakfast of dog food. Initially, we were not overly concerned since she was otherwise acting normally. Then, we noticed a sudden and dramatic increase in the amount of water she was drinking and the amount she urinated – she even had a couple of accidents in the house. Blood and urine tests revealed that Piper had a high calcium level (hypercalcemia), a slightly low white blood cell count and very, very dilute urine. The high calcium level explained the increased thirst and urination but we were not certain what was causing it to be so high. Many things can cause a pet to have a high calcium level including toxins, endocrine or hormone problems, too much Vitamin D, some fungal infections and unfortunately, some forms of cancer (para neoplastic syndrome). To try and find the source of Piper’s high calcium levels, we began to systematically perform further blood tests, x-rays and ultrasound examinations – and while they showed persistent high calcium, low white blood cell count and dilute urine concentration the tests did not reveal a specific cause.
By this point, we were very concerned that Piper had something serious going on. Wemade the decision to take her to Michigan State University Veterinary Teaching Hospital in Lansing, Michigan to be assessed by an internal medicine specialist. Many Canadians are familiar with the University of Guelph Teaching Hospital – MSU VTH is an equivalent institution also staffed by a distinguished team of veterinary specialists and researchers. Both institutions have wonderful reputations for providing advanced diagnostics and care. We chose to go to MSU VTH simply because it is closer and easier to get to from Sault Ste. Marie.
At MSU VTH Piper was examined by a health care team including vet students, interns, residents and internal medicine and oncology (cancer) specialists. Further blood work and diagnostic tests were performed including ultrasound guided biopsies of lymph nodes, internal organs and a bone marrow aspirate. Samples were sent to Colorado State for even more advanced (PCR) testing. These further tests were able to give us an answer but the news unfortunately wasn’t good. Piper was diagnosed with T-Cell Lymphoma – our sweet girl has cancer.
Lymphoma is a type of blood cancer involving a type of white blood cell called lymphocytes that we see not uncommonly in pets. In Piper’s case it has spread to the bone marrow. It is not curable. Even with aggressive chemotherapy, Piper’s projected survival time is approximately six months.
In a word, it is heartbreaking. It is a devastating diagnosis for a relatively young dog (6yrs.) that up until this point has been very healthy. After discussing treatment options at length with the veterinary oncologist, we have decided to treat Piper with a chemotherapy regime that we are both familiar with and has been found to be well tolerated by patients (CHOP or Madison Wisconsin Protocol). We know this regime involving four different drugs will not cure Piper but we are optimistic we can make her feel good and put her into remission for a few months. In other words, we are trying to “buy” her some good quality time.
It has now been five weeks since Piper started her chemotherapy and she is doing very well. She actually feels good! Her appetite has returned (she will raid both the kitchen counter and the garbage can given the chance) and her white cell counts and calcium levels are normal – no more accidents in the house. She is happily soaking up extra attention and affection and she still insists on riding shotgun. To Piper’s delight, manners have becomes secondary. She now unapologetically begs for (and often gets) tidbits of table food and no one complains when she jumps on them in overly enthusiastic greeting. Realistically, we know this won’t last but as long as Piper is enjoying life, we will keep going with the treatment. We will make the most of each day we have together.
It’s time to go – Piper wants a belly rub 🙂