Help Charmer Fight Canine Cancer

2:58 pm I got the call from the Animal Medical Hospital that Charmer was ready to be picked up.  I was anxious as I didn’t know what condition he would be in.  Would he be in bad shape from the anesthesia as he was after his biopsy?  Would he have any pain from the procedure, having his jaw propped open?

When we got to the Animal Hospital, we were pointed to go to the Checkout line, where 2 other pet owners were standing to pay their pets’ bills.  In this hospital you pay first before they release your dog.  No money, no doggie!

After we paid the $893 radiation bill, which included an inhouse evaluation of Charmer for maxillectomy major by the surgeon, the checkout clerk called in the back for Charmer to be brought to us. 

Well I was amazingly happy to see him happy and bouncy, in better shape than when he had come in!

In the photo above he hadn’t yet spotted me and was coming down the hospital hall, passing the front desk.  The radiation technician, Lisa, was leading him over to me.

Lisa, from what Dr Dibernardi had told me, has had 20 years working as a radiation technician.  Lisa told me that Charmer had even eaten a little bit of canned w/d and a/d mixed together.

I asked her if I would notice any kind of changes in his tumor.  She told me generally not with the first treatment, but with the other ones. But she then joked, “You could end up telling me that it shrank by 50% by the end of the week, you never know!”

I was glad to learn that Dr Dibernardi had arranged for the surgeon to look at Charmer while he was doing the procedure, and give his evaluation of a possible surgery.  I had hoped to see if the surgeon could do it next Tuesday when Charmer has his next radiation, but Dr Dibernardi, thank God took care of that on her own.  I left with an estimate of the surgery that I can bring in when I meet the surgeon in person next Monday.

Now I am not committed to a major surgery, I want to see if the surgeon would feel this would be beneficial and a wise surgery to do, and not along the level of trauma the race horse, Barbaro, suffered without any resolution of his problem.

Also, if it turns out that the tumor does indeed significantly respond to the radiation alone, and if the surgeon feels that the surgery would not have any significant difference, that will also determine the course of treatment.

The surgeon quoted a price range of $2427 to $2912, and that would require a 3 day hospital stay.  Already that doesn’t sound good, the 3 days, that is.  But it is a major maxillectomy, so that would make sense.  If it would involve feeding tubes, I don’t think so!  But Dr Carmona told me a couple of weeks ago that it is surprising how well dogs do recovering from that kind of major jaw surgery.

I just came back from dropping Charmer off for his first radiation treatment at the Animal Medical Center.  Charmer had fun barking at all dogs in the waiting room, and people as they strode by.  Before I left my house, I took a look inside of Charmer’s mouth.  I could hardly sleep last night, fretting about how his tumor has grown 50% in size in the last week.  When I originally saw it the day before Christmas, he had about 2 small growths on his palate, each the size of a rice grain.

Now those growths have grown together and are 1/4 on the way to the center of his palate!  His rear molar has been partially dislodged by the tumor growth, so part of the teeth are loose in the tumor.

I suspect this sudden tumor growth has to do with the fish oil I gave him that is loaded with vitamin e.  Vitamin e is a blood thinner, and, guess what?  Tumors feed on blood, and this tumor has lots of veins.  Dumb me did not think about this happening but after the fact.

Why do I think it is the vitamin e?  Because since I spotted the tumor, it had been slowly getting larger, slowly.  Then, bam!  Within 24 hours of my giving him the fish oil loaded with vitamin e, the tumor suddenly grew a perceptible 1/6th in size.  Again, dummie me did not make the connection, and was giving him the fish oil in his food another 2 nghts.  Well, as each day passed, his tumor would again add a significant size, till in 4 days time it had added the size of a walnut which can be viewed in his pictures gallery.

I was wracking my brain trying to figure out why the sudden growth spurt?  I was also trying to figure out why the sudden blood spotting when his surgery seemed to be healing so well the first 7 days.

That is when a light bulb went off in my head:  I remembered when my husband had prostate surgery.  He kept having persistent bleeding the first 2-1/2 months.  We were going nuts trying to figure out why he kept bleeding, and started to try to eliminate dietary as the cause.  Finally we found that the vitamin e in his vitamins was the culprit.  We eliminated the vitamin e and the bleeding stopped within a couple of days.

Since then I have been to surgeries with family members or myself, where the medical community now advises pre-surgery to not have any vitamin e as this will increase bleeding.

That is when I connected the problem my husband had to the bleeding Charmer suddenly had since I started the fish oil.   That is when I looked at the ingredients in the fish oil and saw the vitamin e had been added.

I immediately stopped the fish oil, which I had been giving as recommendations as a good source of omega-3 oils.  Within 48 hours his blood seepage stopped, just as my husband had experienced.  But it wasn’t until a day after that, that I realized that the blood thinning properties of the vitamin e probably had open a flood gate of blood to the tumor, which blossomed under it.

If I only had thought of that in advance, I never would have given it to him.  And the tumor was growing steadily then, visibly by day.  So I got some vitamin K in hopes to cut off the vitamin e’s effect on the blood supply.  Fortunately within 24 hours the tumor stopped growing.  But sadly it has gotten in that time to almost 50% larger than it was a week ago.

That means that all the mass that my veterinarian had cut out on the side was replaced by new one, and what was on the palate just tripled in size so that Charmer is repeatedly making chewing motions with his mouth as he tries to get the mass out of his mouth.  But of course he can’t.

Before that new growth, the tumor had been a manageable size that wasn’t bothering him nor was it visible at all in his cheekbone, when he had his mouth closed.  Now it is a clear bulge that is very uncomfortable to him.

So I was distressed when Dr Dibernardi told me yesterday that the radiation probably would not shrink the size of the tumor.  A week before this sudden growth spurt that would not have been a problem, but now, problem.

That was news to me, and I had a hard time grappling with that revelation.  I told her if it didn’t shrink, something had to be done otherwise because he is having trouble with it.  I asked her what about debulking the tumor.  She told me it would not work with him.

I then asked about the possibility of a radical surgery if the tumor did not shrink.  She felt it would not be an option.  Then I asked what kind of options were there, because he was not comfortable.  She said there were some kind of medications that could be given.  I don’t know if she was inferring to doxycycline which can shrink a tumor by reducing the blood supply, or just palliative pain and corticosteroids.

Since that revelation yesterday, I brought my shocked news to the endless love forum seeking any feedback from other pet owners that had dogs with the same melanoma.  I got pretty much the same feedback to seek another opinion and to seek the opinion of a surgeon, as my doctor is an oncologist, not the surgeon.

I had first been opposed to radical surgery because I am afraid it could be too traumatic for Charmer in the same way that Barbaros, the race horse’s, last surgery was too traumatic for him to recover from.  I certainly would not subject Charmer to such a trauma.  So I had declined Dr Dibernardi when she first met with me and asked if I wanted her to bring in a surgeon colleague for his opinion on radical surgery.

***I just had to stop a moment to accept the express delivery ups package from upco.com that has the enervite and dyne dietary supplements for Charmer.  Dyne is a liquid supplement that supplies high calories for a dog that is unable to ingest enough calores, and enervite is the same type of thing, but in a tube and looks like liquidy malt-colored toothpaste.  I did a palate test to see if it tastes yucky, but found it actually tastes good, and passed the taste test with my other 2 dogs that are not ill***

Back to today’s drop off story: But now that the tumor blossomed too quickly too large in the last week, and now that Dr Dibernardi informed me that the radiation most likely would not reduce the size to my surprise (and I say surprise because i have read in books on pet cancer I have gotten this past month, as well as online that even palliative radiation can noticeably shrink tumors), I now have to figure out what to do get that mass out of his mouth.

I am not okay with his living months, years with this big mass bothering him.  So I made an appointment with the specialist surgeon in the same facility so he can give me his honest opinion if a radical surgery would be beneficial for Charmer, and not a bad choice as it was a bad choice the last time for the race horse, Barbaro.  I have that appointment next Monday.

Dr Dibernardi met with me briefly out in the waiting room, along with the technician who would be perfomring Charmer’s radiation today, and let me know she would be referring me to have a consultation with the surgeon.  She was just surprised that I wanted to see one, letting me know that such a surgery would involve removing his jaw bone, and would cost in the ball park of $3000.

I told her that I had to at least consult with a surgeon, and that if I had to end up euthanizing Charmer down the line because the tumor got too large, at least I would have peace of mind I had tried all options and at the very least had talked to a specialist surgeon.

At that time, Lisa, the technician, came to get Charmer.  She asked me what he liked to eat as they like to feed the dogs when the radiation is over and the dogs come out of anesthesia.  I warned her that Charmer is very hard to feed, even for myself.  Before the tumor he has always been a picky eater, and I could present to him the yummiest prime beef, and he would have to give it a good sniff before deciding if it was anything worth eating.  Then once he decided it was a super treat, he would be eagerly following me for the possibility of more.

But since this tumor, he will only rarely accept even the yummiest of treats from me because his mouth is in pain.  So I have a lot of doubts he will be interested in anything less than cooked people food, and I doubt that the animal hospital has gotten to that level of feeding.  I told them pretty much that, but if he was going to eat, it had to be something very soft because of the tumor.

So I watched my little baby go off on his first radiation treatment, not willingly of course at first, but then he did give into the technician’s kind prodding.

Lisa told me it would probably be longer today then such treatments normally are because it is his first session, and gave me a ball park time of 3pm-ish.

Shortly after I got home, the research veterinarian at the University of Wisconsin gave me a call to answer the questions on the forms I had.  She calmed me that I would not have to worry that they would run out of vaccines or that the study would be closed off to new dogs at any point, because it is a rolling study.  That’s great, because a dog must wait 2 weeks after the last dose of radiation or chemotherapy to participate.  The reason for that is that chemo and radiation interfere with the immune system, and that would render the effects of the immune-stimulating vaccine worthless.

Okay, now it is time to feed my doggies at home breakfast as they were left on hold as I dashed off with Charmer for the drop off.  I didn’t want to feed them in front of Charmer who couldn’t eat before the procedure.

Today Charmer had an appointment to see Dr Dibernardi, his oncologist who will be doing his radiation treatments.  I had faxed her earlier a 4-page long list of questions.  Well there were 8 questions on it about the radiation and then a page asking her to give me an estimate on the Canine Melanoma treatments, with me outlining what the study required to be performed at each visit.

Yep, I was very nervous about possible bad side effects from the radiation related just to focusing a radiation beam to his upper palate area.  In the yahoo groups endless love for owners with cancer dogs, I had read a couple of people whose dogs either went blind or suffered cataracts from the radiation.

Dr Dibernardi told my husband (pictured above with Charmer) and me if he lived past 2 years, Charmer would get a cataract in his right eye which is the side the tumor is on.  I am not a happy camper with that, but it is much better than two cataracts.  Total blindness though, I am not okay with.

Still I asked her if the cataract could be surgically removed and she said yes.  I am getting the vibe from her she does not expect that to be a problem as she doesn’t expect Charmer to live that long.  Well, I hope to prove her wrong.  But even so I will be quite glad if he is around with me for another year or longer.

Just today as I looked at Charmer prancing into the yard, barking at a couple of ducks fighting in the lake, how glad I was that I didn’t just put him down at the diagnosis of cancer, because I really was grateful for each day I had him around. 

I do enjoy him so much that my last few days have been richer.  Why plunge myself prematurely into terrible grief without even trying?  To me the greatest crime I can do is to not try if there is any shred of hope for a positive outcome and my pet is still relatively comfortable.  Temporary disabling times like recovering from surgery is no reason to lose hope and euthanize my dog.  I have resolved that as long as I see that Charmer is enjoying his life and not in any irreversible pain or unresponsive, and I can have the means to give him whatever treatments he needs, I will not jump the gun and lose hope and put him down.