This article is the first in a series. Follow Toni & Roy's journey.
Toni and Lyle Killpatrick's Greater Swiss Mountain Dog 'Roy' is again proving to be a winner by surviving cancer and doing so with grace and gentleness. Roy is a champion many times over and has consistently placed at the top throughout his entire show career, winning the Greater Swiss Mountain Dog National in 2009,making him the number one GSMD in the nation and the coveted title of "Best of Opposite Sex" at the Eukanuba Classic Dog Show last December, 2010. Here is the story of his latest victory.IT WAS JUST A LUMP (pea-sized and firm to the touch) on the inside of Roy’s right ear that changed my dog's life forever.It could be a bug bite, or a scratch from another dog. It could be a cyst or a skin irritation. It could, of course, be a tumor, but that is pretty unlikely. How unlikely, my veterinarian , Dr. Eileen Bissmeyer couldn’t say, so she did a scraping and sent it to the lab. The report came back “benign”. The lump continued to grow and ooze, so the next step was the surgical removal of the entire lump. It was sent to the lab for a biopsy.Hard to believe that three months ago IT WAS JUST A LUMP. Imagine our shock and devastation to hear now, after the biopsy, that it is a Grade III Mast Cell tumor: a Grade III Mast Cell tumor that, without quick action, would likely metastasize and kill within three to six months, what had, up to that moment, been a healthy dog.Just as mast cells are the most common skin tumors in canines, so is the skin the most common site for mast cell tumors. If undetected, they don't usually stop at the skin level. Their aggressive nature means they can invade the body quickly, heading out to the lymph nodes, bone marrow and spleen, taking over before they have barely been detected.The key to how fast they will move lies in the grading of the pathologist’s grading of the tumors. Grade I is a slow-growing tumor that responds well to surgical excision. Grade II is an aggressive tumor that often spreads to the lymph nodes and beyond, requiring more treatment than just surgery. Grade III is a highly aggressive tumor with the greatest spread potential. Excising mast cell tumors is difficult due to the need to get clear "margins". Experts say a three to four centimeter area around the tumor is required to get all the mast cells. Leaving cells behind means leaving the tumor tentacles from which the tumor can grow back. WHAT DO I DO NOW?Having discussed this very carefully with Dr. Bissmeyer, and with as much information as I could gather from the internet, Roy and I headed to UC Davis Veterinary School of Medicine Oncology Department. Our first step after diagnosis was to determine our starting point: Had there been any spread or could we still contain the tumor where it lay? The “staging” that followed consisted of leaving Roy at the clinic for two hours to undergo a battery of tests including a chest X-ray, lymph nodes and spleen aspirates, and abdominal ultrasound.The news that afternoon was mixed. On the positive side, Roy’s test results indicated that the cancer had not metastasized to any of his organs; however, the recommended course of action was to amputate his right ear to ensure the removal of the entire tumor. Since tumor cells can microscopically exist in the nearest lymph node, the right mandibular lymph node would have to be excised also. Dr. O’Brien, the oncologist at UC Davis, also recommended that the surgery be followed by a protocol of chemotherapy.NOW I HAD TO MAKE ANOTHER DECISION:There is no way to tell how a person will react when faced with a life-altering decision, especially one we must make that will alter the life of another forever. I sat looking at my friend Roy for hours at a time, trying to envision his life without an ear, but what is more important, his ear or maybe another three years with him. After long talks with Dr. Bissmeyer and my family, we decided to remove Roy’s right ear and lymph node.Following the surgery we would have two weeks to make a decision about the chemotherapy, while the surgery site heals. The recommended treatment for this kind of cancer is using Vinblastine, alternating every two weeks with CCNU chemotherapy, for a total of six months of treatment. We would also administer prednisone continuously throughout the chemotherapy protocol.The experts say that dogs tolerate chemotherapy very well, but they would need gastrointestinal support, starting approximately three to five days after the first chemotherapy treatment. Roy’s blood work would have to be monitored on a routine basis as chemo can suppress the white blood cells and weaken the immune system.
October 31, 2011:The journey to healing began. Roy’s right ear was removed. A sample of his lymph node was sent to the lab, instead of the full node, because there were too many sensitive structures surrounding it.Dr. Bissmeyer did a magnificent plastic repair on Roy’s ear from the outer skin down to the under skin in a continuous forward interlocking pattern. It appears that, when Roy’s hair grows back, it will cover the top of his ear...The surgery went well. There were no complications. On arrival home, Roy appeared alert and happy to lounge by the fire. There were no bandages and the wound was clean and dry. (See picture to the right). We came home with Tramadol (50mg) for pain and Standard Process Hepatic Support (in anticipation of daily prednisone). Tumors are cut with 3 cm margin from the edge, but Dr. Bissmeyer took at least 5 cm margins.Pathologists examined the remains of the ear and the lymph node aspirate at the Antech Diagnostic Laboratory. The report stated that the margins were TOTALLY FREE from any cancer cells… GREAT NEWS!!!!!! ONE WEEK POST-OP (November 7, 2011):
There was no swelling and there were no complications that week... Roy took pain pills for only three days. He started on a new grain-free diet along with numerous supplements for cancer care.
November 10, 2011:We met with Gloria Garland a board certified specialist in herbal therapy and acupuncture, who works under Dr. Bissmeyer at All Creatures Veterinary Hospital. It was then time to choose chemo or alternative treatment. We discussed what might be best for Roy’s quality of life... I was really impressed with Gloria’s knowledge. She answered all my questions as I tried to make the right decision for Roy... Asking my friends that day, I came to the conclusion that I was not going to poison Roy with chemotherapy.I was not going to let him live out his life being so sick... How would Roy feel about chemo? Is this what he’d say to me? “Why are you making me so ill? I feel horrible I have no energy to run and play. All I do is lie around feeling sick with diarrhea and nausea. You are my best friend. Why are you doing this to me, Mom? I have always given you unconditional love.”
THE NEXT STEP:Dr. Bissmeyer was elated to hear that Roy would be forgoing the chemo for specialized herbal and acupuncture treatment. The decision for this had to come from me and not her. I had to have full confidence in this approach and get full endorsement from Dr. Bissmeyer.Our first treatment, with Traditional Chinese Medicine by Gloria Garland, was under direct supervision of Dr. Bissmeyer. Roy was in the comfort of his own home with his family around him. We will be doing this weekly with Gloria and Dr. Bissmeyer (with Wine and Cheese of course).
For past articles and slide shows click here.
Read the second & third articles of this series: Part 2 & Part 3.