Perkins' mom, Sandi, wrote us to say
Your website, and others on the internet, are an invaluable source of information and hope for those of us whose pets have been diagnosed with that most dreaded of canine diseases - Cancer. But I notice a large number of the letters and message board postings contain stories of some of the worst aspects of cancer treatment, so I wanted to write to you with details of what Perkins, my 14 year old dachshund/beagle cross is experiencing because so far, chemotherapy has been the best decision I ever made!
Like me, I'm sure there are many folks in an agonizing dilemma about whether to treat their pet with another dreaded word - Chemotherapy. The torment for any pet owner who loves their animal is whether to treat - or not treat - the cancer. Quite apart from the financial burden that ongoing chemotherapy will place on them, bigger still is the fear that the cure may be worse than the complaint. I swore to myself that I would not - under any circumstances - submit Perkins, the love of my life, to any discomfort, just so I could selfishly have a little more time with him. As a result, I searched desperately on the internet for some words that would reassure me I was making the right decision in starting chemotherapy. There weren't very many. And this is why I'm writing to you.
In late September 2001, Perkins was diagnosed by his vet with Lymphatic Sarcoma. The only indication that something was wrong were what felt and looked like "swollen glands" under his chin. My vet did a needle biopsy where she removed some fluid from the lumps and sent them to pathology for analysis. Two days later my worst fears were confirmed. Cancer.
After referral to a Veterinary Oncologist and an office visit to discuss the different treatment options, I went home and cried. And then I looked at Perkins, standing in front of me with a tennis ball in his mouth, barking and demanding a game. He didn't know he had cancer. And it was up to me to make the best possible choices for him so he could have more years of chasing that tennis ball.
Our Oncologist was wonderful - she clearly outlined the treatment choices, success rates for both remission and cure, the cost and the potential side effects. Regardless of what choice I made, she assured me that she would help me do only the best for Perkins and that when it came time to let him go, she would let me know long before he would suffer in any way.
I chose what is known as the Aggressive Protocol which is the administration of several different chemotherapy drugs once a week for 8 weeks, followed by another 8 treatments every other week. Perkins went into remission after the first chemotherapy treatment of Vincristine on October 23. "Remission" meant that the lymph nodes were no longer swollen and that the growth of the cancer had been slowed if not stopped. Each week we have visited the Oncologist for treatment - most of the drugs injected using a butterfly catheter in his front paw - a 5 minute process. Just before Thanksgiving he was given a 20 minute IV drip of Adriamycin - the "big" drug in cancer treatment and the one that usually produces the most/worst side effects. I was a nervous wreck just waiting for nausea, diarrhea, dehydration or worse to suddenly appear. They didn't.
Something very important to note is the choice of Veterinary Oncologist. Dr. Harris explained to me that the (somewhat expensive) veterinary fees I'm paying are buying the skills required to accurately calculate how much drug to give her patient that will kill the cancer, and at the same time, minimize if not eliminate the side effects. That "balance" is obviously critical.
We have finished the first 8 weeks of chemotherapy and are now visiting the Oncologist every other week. I am here to tell you that Perkins remains in remission, is as active and playful as ever, is eating well, has barely lost weight, and most remarkable of all, has suffered absolutely no side effects from the chemotherapy administration at all. He still eats his regular dog food (with enthusiasm) and I supplement his diet with a daily 1/2 slow release Iron tablet (children's) to keep his blood cell count healthy. That's all.
My heart breaks for all those who have written about the agonies of side effects from their pet's chemotherapy. I fully expected to see at least some, although hopefully minimal, side effects in Perkins considering he was being filled with highly potent drugs on a weekly basis. But there has been absolutely nothing. Those who know and love him find it impossible to believe that he has cancer, let alone is in the middle of very aggressive chemotherapy.
It is obviously different for every animal on chemotherapy - and there does not seem to be a "pattern" as to who will do well and who will not. But if there is any doubt in someone's mind about not doing chemotherapy because of the unhappy tales (pardon the pun) on the internet, please know that here at least is one much loved dog and his Mom who know that without this lifesaving treatment, we would no longer be together. Over and above that, please know that it is not every animal who will suffer negative effects from this aggressive treatment. The only evidence I have that he has been having chemo at all is my badly depleted bank account. And he is worth every single cent because as of today, January 8, 2002, as I write this, he is happy and feeling great, even if it is on borrowed time. And I am very, very grateful.
I guess he is also living proof that not only the younger dogs should be given treatment, but also the senior dogs. I notice on most of the websites that people are in a dilemma about whether to go with treatment for youngish animals -- no-one seems to talk about 13, 14 or 15 year old dogs. My thought is that if those dogs are still as active and full of life in their twilight years as they were when they were younger, they too deserve the chance at some more time.
UPDATE -- JULY 29, 2002
Perkins finished his 6 months of chemotherapy for Lymphatic Sarcoma on April 23, 2002. Today he remains cured, and even at age 14 1/2 is still vigorously chasing his tennis ball and sunning himself on the patio any chance he gets. During his chemo he showed no side effects at all and there is nothing today that would indicate he ever had cancer. Perkins and I pray that every dog will be this fortunate.
UPDATE -- DECEMBER 1, 2002
Back in July when I last wrote to you with an "update", Perkins was still in remission and no longer getting chemo. In late September 2002, to my horror, after returning from a brief trip out of town and picking Perkins up from the kennel, I noticed the lymph nodes in his neck were enlarged like golf balls again -- exactly the same as when he was first diagnosed with Lymphatic Sarcoma in October 2001.
Of course I was totally freaked out and in tears all over again -- naively I guess I had somehow believed Perkins would be in that 5% of dogs who are cured permanently with the first round of chemotherapy. So we went back to our Oncologist, Dr. Harris, and resumed the same protocol as the first time -- weekly doses of Vincristine, Adriamycin, Cytoxan, Aspariganise (L-spar) and Prednisone. Within a few days of the first dose of injected Vincristine his lymph nodes had returned to normal and I breathed a huge sigh of relief.
Dr. Harris suggested we try the administration of the drugs every 2 weeks instead of every week as in the first go-round. The intention is to administer the chemo only as frequently as is required to keep the cancer at bay and the pet in remission. As Dr. Harris so aptly put it "From now on, we just wing it." What she means is that for every animal it is different. There is not a "set protocol" that works for everyone, first time round or fifth time round. It is a matter of adapting the protocol each time to reach the required result. And I liked that approach because I felt she was focused on keeping Perkins in remission without filling him full of drugs unnecessarily. Let's face it, those chemo drugs can't possibly be good for his system.
Last month, just after a shot of Adriamycin (the supposed wonder drug of chemo), Perkins' lymph nodes came back up. Again. I really lost it that time as I believed if Adriamycin didn't keep the cancer at bay, nothing would. But amazingly a shot of good old Vincristine did the job instead. Since then, Perkins has been taking oral Cytoxan and Prednisone daily (both embedded inside a hot dog!).
Long story short, we're now in December 2002 and on a roller coaster. Dr. Harris has abandoned the "multi drug protocol" altogether after the Adriamycin didn't work but the Vincristine did. Now Perkins usually goes 3 weeks between chemo visits but today as I write, his lymph nodes are back up a third time so I don't know where we go from here. I never imagined at the outset of this fight 14 months ago that it would be so hard to emotionally handle the ups and downs. As I told Dr. Harris, it is the unpredictability that scares me. Not knowing what will happen next and dreading the time when there are no more drugs in the arsenal.
On the upside, the soon-to-be 15 years old Perkins is still his puppy-like self and last night demonstrated this by "digging up" and dragging the Christmas tree skirt out from under the tree and down to the other end of the living room to sleep on!
Sandi Clarke Dallas, Texas