Kole's battle with cancer!

So I am going to dedicate this blog to my wonderful companion Kole. Kole is a 8 year old black male/neutered Laborador/ German Shepherd mix. He's a wonderfully obedient dog that has been everywhere with me in the past 8 years. He's very special to me. Quite possibly the best dog that I've ever had and will have, and I've had quite a few dogs in my lifetime.

On January 8th, 2012 after running 6miles with me, I noticed that Kole was limping. As a veterinarian, I quickly examined his limping leg(which was his right hindleg) and did not notice any swelling or pain anywhere. So I gave him a pain pill that night. That next Wednesday, I came home at lunch to let the dogs out and Kole trotted off in front of me and I noticed that his right hindleg (tibia) just above the tarsus (ankle) was swollen. So I took him

back to the clinic with me to take some x-rays.

The x-rays looked horrible. Basically the distal end of the tibia just above the tarsal joint looked like it was being eaten from the center of the bone out. I knew right away that I was looking at osteosarcoma. There was still a small percentage that it could be bacterial or fungal, but bone cancer was the greatest percentage. I decided that I would have a bone biopsy done to confirm. I owed it to Kole, to know 100% that it was osteosarcoma, before I amputated my dedicated running partner and hiker's leg. I immediately took x-rays of the thorax, because the first place that osteosarc likes to metastasis is thorax.

Thoracic rads were clean. Thank you God!!!

I took him to Heart of Texas Veterinary Specialty Hospital in Round Rock for the biopsy that next Monday. My clinic sends referrals to HOTVSH all the time and whenever I have had a question about a case, I feel very confident calling them to ask for suggestions on diagnosis. I am very blessed to be a veterinarian and be surrounded and part of the veterinary profession. Every vet that I have talked to since this has all happened has been overly compassionate about the situation. HOTVSH has a surgeon on site that was my previous orthopedic surgeon professor at LSU so I knew Kole would be in good hands. They performed abdominal ultrasound and found an incidental adrenal mass. That pushed back the biopsy surgery date a day to run some other

diagnostics. Blood pressure was normal so we all decided to proceed with the biospy surgery until pre-operatively on ECG they noticed an abnormality called a VPC (Ventricular premature contraction).

So the next day they did a echocardiogram (unltraound of the heart) to check out his heart. The echo came back clean. Thank you again God!!They think that the VPC's could be from pain or perhaps the adrenal mass. Regardless, we decided to go through with the biopsy. Surgery went well. They wrapped Kole's leg in a splint to minimize possible fracture. Three days later it was confirmed osteosarcoma.

One week later, one of the doctors at my practice amputated Kole's leg. Recovery has been hard on him. I am optimistic that he will continue to get stronger on his one back leg. He got around okay immediately. It sounds weird, but I miss his leg!

He gets tired quickly now, when before he could go, go, go forever.

Two weeks after getting his leg amputated, brings us to today Feburary 14th. (Valentine's Day)

Today we started chemotherapy. Chemotherapy is a huge unknown to me. I have never had a client do chemo after a diagnosis because of the costs involved and I did not take any special advanced classes or rotations in school to learn about chemotherapy. So it is all new to me. I decided to take Kole to another referral hospital in South Austin called Central Texas Veterinary Specialty Hospital because of the location and the experience that the internal medicine doctor has there. They were wonderful today! I was very nervous about it! They made everything so easy and Kole did great. So today, Kole was started on 250 mg of Carboplatin IV. He is scheduled for 6 treatments every 3 weeks. He's done well after the treatment. The major concern with Carboplatin is decreased WBC count, vomiting, diarrhea, and nausea. So far (knock on wood), Kole has suffered none of the above.

I will keep you updated on his progress though. The good and the bad. My hope is that someday this blog might help one of my patients and clients deal with the prognosis and diagnosis of cancer in their companion animal.

Just yesterday, I diagnosed a 8 year old female Golden Retriever with an abdominal mass that has metastasis to the thorax. The dog has a huge mass in its cranial abdomen (must have been the size of a cantelope) But the dog has acted normal until this past week when she became more lethargic. The x-ray was horrific as the thoracic cavity was filled with nodules. My best guess was adenocarcinoma of the abdomen that has spread to the lungs. This dog is going to die and will die very soon. There is no hope for this dog. It's never a diagnosis/prognosis that I want to give an owner and it never will get easier.