Dena had cancer

[Cassidy's Mom]

I got a call from our vet yesterday afternoon. He got back the pathology report, and it turns out that she had lymphoma. He didn't check her brain or bone marrow, but it didn't matter, there was enough information from her organs. There were no signs that she was sick up until 4 weeks ago, but apparently she had been, we have no idea how long. There were small tumors in her liver, her lungs and her kidneys. At the end she developed DIC, disseminated intravascular coagulation, a clotting disorder that is a complication of some cancers, infection, liver disease, and even blood transfusions, causing internal or external bleeding. Her heart had hemorrhaged, which is what probably finally killed her.

On an earlier visit, cancer was mentioned as a possibility – he said it’s always on the list, but it was low on the list because we had all these other symptoms that led in a different direction. And potentially obvious signs, such as enlarged lymph nodes, were not apparent. Her white cell count was on the low end of the normal range, as were her lymphocytes. He believes whatever she ate caused an insult to the digestive tract and all these other symptoms – the fever, the diarrhea, the autoimmune anemia, and because she was already sick, it overwhelmed her system. But she would have died young in any case.

Having answers is always better than no answers, and it does help to the extent that I can let go of the regrets that we didn't do enough - more tests, more treatments, none of it would have made a difference, she was not going to recover from this. I did some reading about lymphoma last night, and although I haven't discussed it with the vet yet, it seems like it was a catch 22 situation. You need to boost the immune system to fight lymphoma, but her immune system was killing her red blood cells and platelets. You need to suppress the immune system to reverse that process, but then the lymphoma is unchecked. I don't know if that's exactly what happened, but it seems like treating one problem would hasten the progression of the other, no matter which problem we treated.

If she hadn't gotten sick a few weeks ago, her lymphoma may have been undiagnosed awhile longer, until she started showing symptoms. Untreated, dogs typically last 4-6 weeks after diagnosis. With treatment they can go into remission for 6 months, a year, a year and a half, but most do not last much longer than that. I would have gladly taken that extra time with her, but it wasn't in the cards.

Dr. Schuchman has spoken to an oncologist, and is waiting to hear back from another specialist. I know he wanted to save her, and is trying to find out what happened, if there was anything that he missed that should have led him in that direction. He's doing this on his own, we had actually decided not to request a necropsy, partly due to the expense - it's one thing to spend thousands of dollars to make your dog better, but another thing entirely to spend thousands of dollars only to lose her, and then spend more, but also I was afraid to find out that a decision that we made may have caused her death. So it's comforting to know that there wasn't anything more we could have done, but it makes me incredibly sad to know that she was always doomed to live such a short life.

We need to go back to settle the bill, (although I have a feeling we won't be charged for a lot of stuff), and to pick up her bed, so I'm going to make sure that we go when Dr. Schuchman is there so we can talk with him and ask more questions. I'd like him to go over it with Tom there too because I know I missed a bunch of stuff the doctor said. I tried to take notes, but there were medical terms I'm not familiar with, and I think he'll want to ask questions of his own.

[LJsMom]

I'm glad you know what took Dena to the bridge. Its all so sad.

[valb]

Thank you for letting us know. I don't think I will ever really
understand cancer. How a dog that is so seemingly healthy could
have been living with that hidden.

[JeanKBBMMMAAN]

I am glad you found out. Nina had lymphoma as well. What the internists and oncologists (along with all the other teams working on her-endicrinology was involved I've found it out as well as neurology) from Cornell said, when I decided not to do the additional testing needed to set her up for chemo (which was a hindsight wonderful decision-she would have passed away there before she could have even started chemo) was that if the prednisilone didn't give her a boost, that chemo wouldn't have worked either.

So I hope that helps you-Dena was on steroids and got no bump from it.

Please let me know if you have any questions. I did try to do a crash course on lymphoma in the few days from her diagnosis to her passing. There are "good" lymphomas-where dogs go into remission and live a great life-there is one on IMOM right now-a lab, who has been around for a while.

I do hope that this is something that the vet thinks about though-when you have a case that is so complicated, refer out to a facility with teams of people who do that type of work all the time.

Maybe I shouldn't say that. I am though because in reading this result I feel that there was nothing that a diagnosis would have done, other than prepare you better, and even with that, you are never really prepared. I am saying it so that other people can ask for referrals and also so that you know that this was something where you did everything you could, and that nothing you could have done would have changed that tragic outcome-diagnosis or not-so you are not to feel badly at all. But vets need to use the resources available to them, like we all do in our jobs. If you want this edited out, I won't be upset.

I am so sorry that a dog that young could have such an awful version of that disease. And I feel so badly that you had to go through something like that with her. It is an awful experience.

[GSDLoverII]

At least you will have some closure now, knowing what it was that took Dena's life.
Thank you for letting us know.

[Annikas Mom]

I am glad you have closure, it doesn't bring her back but it does help to have an actual diagnosis. Lymphoma is one of the terrible cancers that take our beloved breed way too young.

I totally understand spending thousands of dollars only to lose her, I would have spent thousands more if I could have saved Annika but her frail body couldn't take anymore... We never did get a diagnosis from her necropsy which is very difficult, not knowing messes with my mind often... We had 6 different doctors woking on Annika's case at the time but one of the doctors, on her own time, spent weeks researching the necrospy results and discussing them with many specialists all over the country. I think she was as devastated as we were that we lost Annika. She has a picture of Annika on her desk. My gut tells me this is the kind of vet you have, they are priceless!!

I think of you and Tom everyday and hope that you are able to smile through your tears when the memories come flooding back at the most unexpected times. Dena took a piece of all of our hearts with her when she died but I know that piece is much bigger for you and Tom...

Hugs to you both.

[GSD10]

Debbie,

I also am glad for you and Tom that you have some answers. I agree, knowing is better than not knowing, although still not taking away from the tragedy and sadness of it all for your loss.

I don't know what is going on in the world of dogs were cancer is just much to common these days.

I am thinking of you all. How is Keefer holding up?

[LJsMom]

Well said Jean.

[Cassidy's Mom]

Originally Posted By: JeanKBBMMMAANI do hope that this is something that the vet thinks about though-when you have a case that is so complicated, refer out to a facility with teams of people who do that type of work all the time.

Maybe I shouldn't say that. I am though because in reading this result I feel that there was nothing that a diagnosis would have done, other than prepare you better, and even with that, you are never really prepared. I am saying it so that other people can ask for referrals and also so that you know that this was something where you did everything you could, and that nothing you could have done would have changed that tragic outcome-diagnosis or not-so you are not to feel badly at all. But vets need to use the resources available to them, like we all do in our jobs. If you want this edited out, I won't be upset.

No, it's fine Jean. I agree that it could be helpful for others. If it had been JUST the autoimmune anemia the prognosis would not have been great, I read on one site that the survival rate is 40-60%. And if it had been JUST lymphoma, we would have had her a bit longer, but it seems like she had the perfect storm of illness. Everything we could do to treat her could potentially cause life threatening complications. But not doing it was potentially life threatening as well.

I know that my vet is trying to learn as much as he can about what happened, and I really appreciate his commitment. He's doing this on his own because he wants to, not because we insisted. She's gone, nothing we learn now will change that, but there may be lessons here that could help another dog at another time.

[littledmc17]

Again I am so sorry about Dena not fair she was way to you.
At least you have answers not that it brings your sweet girl back to you but it is closure.
You did everything you possibly could for her, she knows it and loves you for it.
I hate the fact that cancer can get our babies and its not fair they can't tell us whats wrong with thing to a point.

SHe is running around in no pain now, waiting for the day she can be reunited with you.

Hugs and we are all with you in this loss she was a beauty