The most terrible things about life

I grew up with two golden retrievers, Luke and Rusty.  There was nothing better than seeing their expression of bliss when I got home from school, seeing the satisfaction they received from bringing me back a tennis ball, or the comfort they brought me when I was feeling down.  I thought of them the day I met Ginger.

Ginger’s family learned this year that osteosarcoma is the most common primary bone tumor of large breed dogs, often occurring in the metaphysis of the long bones.  Unfortunately, most owners of a dog diagnosed with this cancer are confronted with a decision of whether to amputate a limb or to help the dog maintain its quality of life as long as possible while living with this painful bone lesion.  The outcome of this decision varies and is dependent on several factors.   When it comes to making sure you are making the right decision for that loyal companion, you want to be sure that you have all of the information you need to make it.

Several people have told me that I must have been temporarily insane when I chose to become an oncologist.  Cancer and chemotherapy are not words that people look forward to hearing and chemotherapy is certainly not something they look forward to giving to their pets.  I have even been told by my clients “I hope I never see you again, Dr. Linderman” and I tell them “The feeling is mutual.”

This aspect of the job is quite challenging, but the results make it worth coming to work every day.  It is not always the right decision to perform a radical procedure, such as an amputation, or to recommend a course of chemotherapy; but, for the right patients, it is a life saving decision.  The video attached to this blog was taken 6 months after Ginger’s amputation.  Like most dogs after surgery, she had no side effects while going through her course of chemotherapy.  No evidence of recurrent disease was seen on the work-up that day and we are looking forward to seeing her beautiful face again in 3 months for another quick check up.

 I once watched a documentary about the artist Bruce Bickford and learned that there are two terrible things about life:  1. “it is so terrible” and 2. “it is so short!”  While cancer is one of the most terrible events that life has to throw at us, we do not have to give up.  There have been many incredible advances in veterinary cancer care.  With a little sacrifice in the right places, we can find hope and continue to give back to our pets the same devotion they show us.

Dr. Michael J. Linderman


"Ginger just a few week after her surgery"

"A hug can be a very powerful thing"

I would like to remember a very special patient in this month's blog.

I can still remember getting ready to walk into the exam room to meet Pebbles for the first time. I was all caught up on her previous medical history and was fully prepared to discuss her recent diagnosis of Lymphoma and to make a treatment plan with her owner. What I was not prepared for was the amazing greeting that I would receive upon entering the room. I walked into the room and exchanged a very pleasant greeting with Pebbles' mom who I would grow to be good friends with but this was not the amazing greeting that I am referring to. The AMAZING greeting was yet to come.

 

I looked at Pebbles for the first time and she looked up at me with warm, loving eyes that asked me to bend down without ever saying the words. I knelt down to say hello to Pebbles and she offered me one front paw and then the second and then leaned forward to hug me.

Well, that was the most amazing greeting I have ever received. I was extremely blessed to receive such a greeting from Pebbles at every one of her visits with me. I would look forward to her hugs and to the joyful spirit that she had at each visit that seemed to be contagious when you were around her. She was a living example of both joy and comfort as she brought both feelings to all those she came into contact with. I would often tell Pebbles' mom that I wasn't quite sure that Pebbles was really a dog as she had such perception of human emotions and seemed to constantly speak to you with her eyes. Pebbles enjoyed an excellent quality of life and truly understood how to live in the moment. I learned so much from her and I will forever be a better person for having known this very special dog.  I know Pebbles’ mom feels the same way and she wrote the below in honor and memory of her sweet girl.

Gina Olmsted, DVM

Remembering Pebbles-Authored by her human mother

We all believe our dogs are special, and each one is in his or her own way. But I know Pebbles was a gift from God. I walked into a shelter almost 10 years ago, saw this beautiful dog right away, and said, "tell me about that dog." The staff raved about her, how sweet she was, how obedient, how calm, but most of all, how loving she was. They loved her and there were tears when she came home with me. I waited three weeks while she was treated for mange. I visited her every day, and ignored the "don't touch her” advice, putting my hand through the bars of her kennel door. She would put her head right in my hand.

I have dreamed about Pebbles twice that I remember. The first time she was running away from me across a huge field alive with butterflies, flowers and trees, a brook, puffy white clouds in the sky. I called and called her, but she would not come to me. I went home, crying all the way and woke up crying. Then I realized she was running across the Rainbow Bridge and that no matter how long I called for her, she was now in a different world, and she was happy and excited. When she first died, I would shout at her picture, "I want you to come home!" The dream was the answer to my cries. The next time I dreamed about her she was no longer a black dog; her fur was all white. I knew she was an angel-dog now. She was an angel in life, too. She was a Therapy dog and we visited Griffin Hospital in Derby for several years. Patients loved her; Doctors and nurses got down on their knees to greet her and she knew where the snacks were kept for her. She was everybody's favorite.

She sat up on her haunches to greet you and first gave you one paw, then crossed her paws and gave you two, or put her paws out to hug you... She was a happy, loving dog who never withheld her affection and trust. I wish I could be more like her. Even when she started being treated for Lymphoma, she bounced gaily through the front door... but then I had to walk with her down the hall to get her into the treatment area. She did not want to leave me in the waiting room. She was blessed with the most wonderful care-givers any patient, human or canine could ever have. I will always be so grateful for the love they gave her. And the extra time they gave us.

When she died I received dozens of cards and tributes, and a wonderful blanket with her picture on it that I cuddle up with in the evenings. It makes me feel close to her. One of my friends wrote, "the world is a lesser place without Pebbles." This says it all. I love you, Pebbles, and miss you with all my heart.

 

New Experiences

I started working for The Veterinary Cancer Center roughly 3 months ago as the new Referral Coordinator.  When I started with The Veterinary Cancer Center a few short months ago, I had no idea how incredible this place was and the profound impact The Veterinary Cancer Center has played in so many people’s lives.  I came to The VCC with no prior medical knowledge or veterinary experience looking for a new challenge, and to find a career that I could be passionate about.  What I found when I got her was all of that and so much more. 

As I mentioned, I do not have a background in veterinary medicine and, to be completely honest, I never would have thought my career path would have brought me to The VCC,  but I am fortunate that it did.  I have spent a large part of my career in sales, marketing and management so the question I am often asked is “How did you end up working at The Veterinary Cancer Center.”  Well the answer to that question is easy… I love animals and I was presented with an opportunity to be part of a place that helps pets and their owners during a very difficult time.  The VCC provides hope to pets and their owners when, often times, there is very little and that is something not only to be passionate about,  but to be proud of. 

During a time when so many people are either looking for a job, or find themselves in a job that does not make them happy,  I am extremely thankful that I was brought in to be part of The VCC team.  Almost everyone I know either has had a pet with cancer or knows someone that has so,  I am very familiar with how difficult it can be.  It can be one of the hardest things to deal with and to know that I work for a place that will do everything to provide hope for the pet and the owner is pretty powerful.  For those of you that have a hard time believing what you reading, I urge you to come down to The Veterinary Cancer Center and see for yourself.  Once you do, I assure you, that you will be just as amazed as I was when I walked through the door.      

Ryan Shepherd

When the Doctor Becomes the Patient

     Cancer is a scary word. Usually I am the one giving the diagnosis or discussing the prognosis and treatment with heart broken pet owners. It is a lot different when my pet is the one with the diagnosis and I am the one hearing about the prognosis and treatment. Two of my own dogs have previously been diagnosed with and treated for cancer. As a pet owner it was devastating for me but as a veterinarian it was an invaluable lesson into the emotional roller coaster my clients endure on a daily basis. 

     As many of my clients and friends know, I love basset hounds! My current basset hound, Walter, is my third basset. I got Walter about 2 years ago, several months after losing my second basset, Kirby. Kirby was a "special needs" basset hound, whom at 8 years of age found himself in search of a new home. I found Kirby (or maybe he found me) when he was almost nine. We had 3 and a half great years together when he was diagnosed with lymphoma. I was devastated, but as a fourth year veterinary student I knew a few things about lymphoma and took Kirby to see an oncologist right away. I already knew that I wanted to be as aggressive as possible while maintaining Kirby's excellent quality of life. Kirby was quickly started on an injectable multi-agent chemotherapy protocol (the CHOP protocol). As a vet student I knew that Kirby's lymph nodes were supposed to shrink quickly and return to normal after receiving his first treatment. I checked his lymph nodes multiple times a day waiting for them to get smaller. But days went by with no change, he had further treatments, weeks went by and still no change. Kirby still felt great and was handling his chemotherapy well but his lymph nodes were not budging. I was again devastated, the chemotherapy was not working. 

    But I wouldn't give up and neither did Kirby's oncologist. We decided to switch to a different treatment protocol, one in which Kirby received oral medications by mouth daily. Again, I hopefully felt his lymph nodes every day, willing them to get smaller. Again, there was no change in the size of his lymph nodes. I was starting to feel defeated, but lucky for me and for Kirby, his oncologist was not defeated. We switched Kirby to yet another treatment protocol. Full of new hope, I continued my ritual of daily lymph node palpation. This time it worked! Kirby's lymph nodes were normal and he still felt great! I was beyond thrilled. Not only did the new protocol give me 5 additional months with Kirby (who sadly was euthanized for a reason unrelated to lymphoma) but I also learned an important lesson; never give up hope. Sometimes hope is all we have, we hope that the next treatment will work, we hope that our friends continue to feel well during treatment and we hope that when the time comes to say good bye it is peaceful. Kirby and his doctors taught me a lot and because of them I will always have hope for my patients and my clients.

JenniferMcDaniel, DVM

The Missing Link

As I toyed with the idea of going back to school to become a Registered Nurse (for humans), I found myself teetering between an unwillingness to leave veterinary medicine and a desire to further my education in order to elevate my level of medical knowledge and clinical skills.

 

It seemed that the more I learned here, at The VCC, the more that I realized how fascinating the field of Oncology was. I would hear Dr. Post frequently referencing human Oncology literature and I started to appreciate the undeniable link between veterinary and human Oncology.

I realized that going to Nursing School did not mean that I was going to be forced to make a choice between animals and people. It was becoming clear that Oncology was Oncology and that really, there didn’t need to be a line drawn between the species that I would work with.

Now that I have graduated and am proud to be both a Licensed Veterinary Technician and a Registered Nurse, it is all starting to come together with my new role as Clinical Trial Coordinator.

Maybe you’re wondering what it is that a Clinical Trial Coordinator actually does…. Check out my next blog to hear more about I get to help patients receive cutting edge treatment (sometimes for free) while at the same time helping to further research for animals and humans with cancer!

 

Maria Salas, LVT, RN,  Clinical Trial Coordinator for VCC

LEXI

I brought Lexi home as an 8 week old puppy in November 2001. She was a beautiful brindle boxer/pit bull mix who got me in quite a lot of trouble with my landlord, as I wasn’t allowed to have pets in my building – as any true pet lover knows, rules about animals are merely suggestions that don’t necessarily need to be followed! We always had fun rollerblading when we lived in Hamden, she would wear a harness and drag me sled-dog style down the bike trail, and when I moved into Fairfield, St. Mary’s in Black Rock became our new favorite place to hang out – she loved to swim in the marsh at high tide. Her brother Roscoe, a boxer, came into our lives in 2004, and she had a constant companion from then on. She lived a very comfortable doggy life in our home in Stratford, we have a big yard where her and Roscoe ran and played, and a big couch to spread out on inside. Her tail would wag so hard she would leave bruises on your leg (and knock more than a few things off the coffee table). Anyone who knew Lexi knew her tail.

In April of this year, I came home to find my previously perfectly healthy dog had a distended belly, and my 10 years of training in veterinary medicine told me that something really bad was going on – despite the still wagging tail. Cancer was at the top of my list of “what could be wrong,” and unfortunately, I was right. I said goodbye to Lexi in July, but she didn’t go down without a fight, and her tail never stopped wagging. I’ll talk more about the path we took through emergency surgery and aggressive chemotherapy next time. For now, I want to share one of my favorite pictures of her with you. Thanks for taking the time to follow our story.



Allyson Stewart, CVT, VTS (Oncology)

November has been renamed “Movember”

No, that is not a typo.  November is Prostate Cancer Awareness Month and an international movement started in Australia, Movember—was started in 2003. Movember events have raised $126 million since 2003, with all the funds donated to charities that target men’s health issues-- the Prostate Cancer Foundation and LIVESTRONG Foundation.

Prostate cancer does not just affect men; dogs also get this form of cancer. It is thankfully an uncommon disease, but it does occur in both neutered and intact dogs. The signs of prostate cancer in dogs are straining to urinate, bloody urine, back pain, and/or straining to defecate. Diagnostic tests include a good physical examination (including a rectal examination), urinalysis, abdominal radiographs, abdominal ultrasound, and a biopsy or cytology to confirm the diagnosis.

Therapy for prostate cancer in dogs is different from treatment in men. As all of the prostate cancers in dogs are androgen-independent, anti-androgen (anti-testosterone) therapies do not work. In addition, the cancer in dogs is usually highly malignant. Surgical removal of the prostate gland in dogs is very difficult and is only effective when the tumor is detected at a very early stage. The typical therapy involves NSAIDS (non-steroidal anti-inflammatory drugs), chemotherapy and radiation therapy. The Veterinary Cancer Center in Norwalk, CT (www.vcchope.com) conducted research on the use of chemotherapy in dogs with prostate cancer and is gearing up to continue that research by evaluating the use of highly targeted radiation therapy--IMRT (Intensity-Modulated Radiation Therapy) for the treatment of this disease.

How you can help---Please visit http://us.movember.com/team/777069 and donate to our Team. The money raised will help find an end to this all too common and devastating disease of men (and dogs).

Dr. Gerald Post