We’re back in Philly, well, Parkesburg, PA for the night, but Philadelphia tomorrow for Sasha’s second treatment in the Mason Bone Cancer Study at the University of Pennsylvania. We drove up to Pennsylvania from Raleigh, NC today, and we are spending the night at my parent’s home. We’ll head to UPenn tomorrow at about 7AM in hopes of getting there at 9AM to meet with Dr. Mason.
Sasha has been doing well; full of life and spunk. She did great the last time she was in Dr. Mason’s care, and I expect everything to go well this time, too. Dr. Mason is excited to see Sasha, and, apparently, so are some of the other staff at the UPenn Vet School. It seems that Sasha has earned a bit of a celebrity status at the school.
Liliana and I are planning to visit the University of Pennsylvania Museum of Archaeology and Anthropology tomorrow after dropping Sasha off with Dr. Mason, but I’ll be sure to write an update on how our visit at UPenn goes, and I’ll also introduce you all to a beautiful dog named Dolly. Dolly is scheduled to be the third dog to participate in the Mason Bone Cancer Study.
About a week has passed since we returned to Raleigh from Philadelphia, where Sasha received her first treatment in the Mason Bone Cancer Study. She is doing extremely well! Take a look at this video:
We took Sasha to our local vet on Wednesday to have blood drawn and sent to Dr. Mason at UPenn. During her stay in Philadelphia, Sasha’s liver enzymes rose to above normal levels. Click here to read about Sasha’s first treatment at UPenn. Dr. Mason was not too concerned about the elevated enzymes, as this reaction to the vaccine was reasonably expected.
Christina, a wonderful veterinary technician at Brentwood Animal Hospital, our local vet’s office, was tasked with drawing Sasha’s blood. She is a bit of a phlebotomy hotshot with a knack for finding good veins quickly. Unfortunately, this time Christina did have some difficulty guiding a syringe into Sasha’s vein. She switched from Sasha’s leg to her arm and quickly found her mark. Sasha was ready to leave after being poked, and Christina had all the blood she needed to send to Dr. Mason.
Sasha’s blood arrived at UPenn the next day. Tests were run, and Dr. Mason let us know that all of Sasha’s numbers looked good. Her red and white blood cells were normal, as were her platelets, and her liver enzymes were falling nicely, too. Dr. Mason even sent us a graph where she plotted Sasha’s liver enzyme values so that we could see the downward trend, visually.
Dr. Mason explained that the probable cause for Christina’s difficulty in finding a good vein to draw blood from in Sasha was that she may have been dehydrated. She said that the sample of blood showed that her proteins were within normal parameters but at the top end of normal. She also said that Sasha’s sodium level was a little high. High blood proteins and high sodium levels are indicators of possible dehydration. Another possibility is that sometimes the vessels where chemotherapy drugs are administered can become damaged, and are difficult to draw blood from.
Dr. Mason told us that the article on the study in the Philadelphia Inquirer brought several more dogs forward, and her team is currently screening their tumors for the Her2/neu expression. There are currently 7 recruits and 3 or 4 being screened. We hope these dogs make it into the study, and that they all do as well as Sasha has done so far! Good luck to all!
History was made on July, 10, 2012, when Sasha underwent her first round of treatment in the Mason Bone Cancer Study at the University of Pennsylvania School Of Veterinary Medicine. The study takes a novel approach to fighting cancer using a recombinant L. monocytogenes vaccine to, hopefully, cause anti-tumor activity of the body’s immune system. Liliana and I drove to Pennsylvania with Sasha, Argus and Alli (the Three Musketeers) on Monday. We are lucky that my parents still live in PA, so we had a place to lay our heads for the duration of Sasha’s stay at UPenn.
We met with Dr. Nicola Mason Tuesday morning. I cannot say enough good things about Dr. Mason. Entering Sasha into the first phase of a clinical trial was not an easy decision to make. Allowing her to be exposed (intravenously) to Listeria monocytogenes bacterium and leaving her in the care of people that we do not know at a large University did not make the decision any easier, but Dr. Mason put our worries to rest and our minds at ease. Whenever Liliana and I speak with Dr. Mason, we always feel that she genuinely cares about Sasha, and she makes a great effort to ensure that we understand everything that will happen during the trial. She also called us several times each day while Sasha was in her care to give us updates about how our girl was doing. We feel very fortunate to have been able to enroll Sasha in this innovative approach to treating bone cancer in dogs, humans, and other animals.
Administration of the Listeria monocytogenes vaccine began at about 2:00 PM on Tuesday and lasted approximately one hour. The first sign of evidence that Sasha had been exposed to the ‘bug’ came a few hours later. She developed a mild-to-moderate fever which peaked at 103.8 (normal temperature for dogs is 101.5) at around midnight. The fever was easily kept under control with IV liquids and a fan blowing on Sasha. The fever was a good sign, as it indicated that Sasha’s immune system recognized the Listeria, and was actively fighting it.
The idea behind the Mason Bone Cancer Study is to train Sasha’s immune system to find and attack cancer cells. Normal cells divide by a process called mitosis. Mitosis occurs at a regular rate, and each cell produces two identical daughter cells. Cancer cells are essentially bad copies of parent cells. The DNA of the parent cell is not replicated perfectly during mitosis, and mutant cells are born. These mutant cells do not behave normally. They do not die when they are supposed to – a process genetically hardwired into each normal cell called apoptosis. Instead, cancer cells multiply, often at accelerated rates, and can form tumors. Note: not all tumors are cancerous, and not all cancer cells form tumors, i.e. leukemia. Unfortunately, the mutant cancer cells are not so different from normal cells that the body’s immune system recognizes them as a threat.
The Listeria bug used in the Mason Bone Cancer Study has been genetically modified to express a protein called, Her2/neu. Sasha’s cancer cells also produce this same protein. By injecting the Listeria into Sasha, the hope is to elicit an immune response. Since the listeria used expresses the Her2/neu protein, Sasha’s immune system will become programmed to recognize the protein as a dangerous invader and attack it. The hope is that her immune system will now also recognize any cancer cells in her body as dangerous invaders and attack them, as well.
The day after Sasha’s vaccination, bloodwork showed that she was mildly anemic and that her platelet count was lower than normal. These counts returned to normal the following day. Dr. Mason explained that the likely cause for the low platelet count was the vaccination caused her platelets to adhere to the lining of her blood vessels, thus removing them from the bloodstream, and causing the low reading from the collected blood. The temporary low count of Sasha’s red blood cells (anemia) was probably due to her blood being diluted as a result of the intravenous fluids she received to keep her temperature in check the prior day.
More bloodwork was performed on July 12th. The results showed that Sasha’s liver enzymes were on the rise. Her elevated liver enzymes, ALT (Alanine transaminase) and AST (Aspartate transaminase), are likely elevated due to inflammation caused by the vaccine. Similar findings were documented in human patients that received a comparable Listeria vaccination. Dr. Mason told us that Sasha’s elevated liver enzymes were not something to be alarmed about but that they should be monitored. She asked that we schedule an appointment with Sasha’s regular veterinarian, Dr. Neuenschwander, to do follow up bloodwork on Wednesday or Thursday of this week.
Dr. Mason said that Sasha was a trooper throughout her whole stay at UPenn, and took all of the poking and prodding in stride and without complaint. The only sign that Sasha may have been feeling under the weather is that she did not seem to have much of an appetite. Dr. Mason made several attempts to get Sasha to eat, including hand feeding her, but Sasha was not interested until she was presented with some yummy canned food. Again, our gratitude to Dr. Mason for taking such good care of Sasha.
We are back home in Raleigh, NC now, and Sasha is doing great. She is still being a little picky with her food; however, we believe that her appetite is fine. Sasha is a smart girl, and she learned quickly that by turning her nose up to her regular kibble, she would be offered something tastier. She retrieved her Kong flying disc several times this morning and was as fast as ever! We hope to take her swimming sometime before the return trip to Philadelphia.
Thanks to everyone for reading about Sasha’s battle against cancer, and Dr. Mason’s innovative work. Thanks to Dr. Mason and her team at UPenn School of Veterinary Medicine. Thanks to my parents for providing me and Liliana with food to eat and a place to sleep. Thanks to Greg Goldberg (basically my brother-in-law) for staying at our home in Raleigh and taking care of our other dogs while we were away.
I will continue to chronicle Sasha’s progress here on Lili’s Notes. Please come back to see how she’s doing!
PS. I’m famous! Check out this article about me and the Mason Bone Cancer Study in the Philadelphia Inquirer.
Several weeks have passed since I last posted here about my dog, Sasha. My husband and I brought Sasha to our local veterinarian on March 6 because she was showing lameness in her right arm. X-Rays revealed that Sasha had a growth on her humerus bone. Our veterinarian explained to us that the growth was a tumor and was the result of osteosarcoma. Osteosarcoma is the most common and aggressive type of bone cancer seen in dogs. The tumors usually occur in the limbs of large breed dogs. The prognosis was not good. We had three options (with slight variations of each) of how to proceed. The first would be to do nothing. Sasha would be in extreme pain for the rest of her time with us, and would likely not live beyond two months. The second option would be to amputate her arm, which would provide her relief (after recovering from the surgery) from the pain caused by the osteosarcoma. The positive thing about moving forward with the amputation, besides pain relief, would be that Sasha would be with us for longer. The median survival time for dogs with osteosarcoma after limb amputation and no further treatment, is six months. The reason for this is that once an osteosarcoma tumor has been found, the chances that the cancer has already metastasized to another part of the body – usually the lungs – are extremely high. The third option would be to have the limb amputated, and then follow up with chemotherapy treatments. Taking this option meant that we might have Sasha, pain free and happy, for 6 months to a year, or possibly longer if we are lucky. We decided to go with option three.
Since we learned of Sasha’s diagnosis, we have been researching osteosarcoma, reading about experiences of others with dogs diagnosed with osteosarcoma, and exploring additional and alternative treatments that might help our beloved dog. On May 8th, via the Facebook page, Chase Away K9 Cancer, I learned about a new vaccine available for bone cancer. Since then, my husband and I have been looking into enrolling Sasha in the clinical trial in which the vaccine will be used for the very first time with dogs.
We spoke with Dr Mason, the doctor who is heading the trial, and a superbly nice person, and she explained to us that the patients would be injected with listeria bacteria. It would be a very low-potency (for lack of better word) listeria bacteria, but the idea is that the listeria would hone in on a certain gene marker in Sasha’s tumors, and then her body’s natural defenses would attack the bacteria, and by association, the tumors. It is a novel approach to treating osteosarcoma in dogs, but it has been used in mice and in humans with some remarkable success.
In order for Sasha to enroll for the trial, she would need to meet certain criteria:
She needed to be diagnosed with osteosarcoma, and the tumor site had to be one of her limbs.
Her affected limb had to be amputated
She needed to undergo four treatments of chemotherapy with carboplatin
She needed to have the her2/neu gene
Sasha met, or would soon meet, three of the criteria necessary to qualify her as a potential patient in the clinical trial. The only thing that we needed to find out was whether Sasha’s tumor expressed the her2neu gene. To find this out, we needed to contact the lab where Sasha’s tissue block had been sent off to for analysis. Dr Mason had told me that for the sample to be viable, it needed to not have been decalcified. I was so happy to hear that the lab still had her tissue block after over a month, but I was dismayed to learn that it had been decalcified. Because of my high hopes for the clinical trial, I was very upset to hear that the tissue sample was no longer viable. I sent Dr Mason an e-mail informing her of the bad news. I was surprised when she responded, and said that she would be happy to test the sample, even though it had been decalcified, to see if she could determine if Sasha’s tumor sample expressed the her2/neu gene.
A few days later I received and e-mail from Dr Mason. She explained that tests had been performed by multiple people, and they were all confident that Sasha’s tumor did, in fact, express the her2neu gene. This was such happy news for us, as we felt very positive about the Mason bone cancer clinical trial.
It is now, June, 19, and Sasha completed her final carboplatin treatment on the Monday June 11. We will need to take her to our local veterinarian’s office on the June 25th and again on July 2nd, to have blood drawn to make sure that her immune system is strong and ready for the listeria injection. If all goes well, we expect to drive up to Philadelphia the second or third week of July. Sasha will need to remain at the University of Pennsylvania, School of Veterinary Medicine, for three days. There, she will be constantly monitored by Dr Mason and her team to ensure that everything goes well. Dr Mason explained that she expects Sasha to feel flu-like symptoms and have an elevated temperature – similar to what people experienced who underwent this same treatment. Her temperature should be back to normal levels by about the twelve hour mark after administration of listeria.
Thank you for reading this update on my dog, Sasha. She is doing very well now; full of life and spunk! Sasha still enjoys going to parks and running after her favorite toy, a red Kong frisbee. She also loves to go swimming, and does just as well as she ever did in the water – no life vest required.
I will post again to keep you all abreast of Sasha’s progress.
After long and thoughtful consideration about our next steps in treating Sasha’s caner, Carlos and I decided to proceed with Chemo.
Thursday, March 29, was our consult with Dr. Waddle, and turned out to be Sasha’s first Chemo treatment. Per our vet’s recommendation, we went to Veterinary Specialty Hospital here in Raleigh, and spoke with the oncologist, Dr. Waddle. After learning more about the treatment, side effects, cost, etc., we decided to move forward with treatment. We ended up having to leave our girl at the Hospital for a full check-up, and the chemo administration which is given via IV.
We were sure that when we’d pick her up, Sasha would be disappointed and sad with us for having left her. While we waited for Sasha, we went to the Fabric Mill Outlet. We had wanted to check out the place for a while, but had not gotten around to going. And now it was a good opportunity because it is next to the veterinary hospital. We purchased some poly fill for extra stuffing for a few dog beds back home. We also went to Durant Nature Park, a place where we often come with our dogs. We walked the trail where we normally let our dogs swim. During our walk, we scouted for other spots for Sasha to go swimming; now that she’s a Tripawd, we wanted to find easier spots for her to get into the water instead of running and plunging like she used to do before the amputation. After the park we drove around nearby neighborhoods and looked at houses. We pointed out and talked about the ones that we liked and would like to live in. We like the house where we currently live, but we would like to have a place with more land. A ranch or a farm would be nice, and we think the dogs would agree. After a couple of hours we headed back to pick up Sasha, but she was not ready. The hospital was busy and her treatment got started later than expected. Carlos and I were starving, so we headed to a nearby place to grab something to eat (more on this on a separate post). After about an hour, we finished eating, and got in our car. I was about to call the hospital because we couldn’t wait to see our girl, but before I was able to dial, the call came in to come and get Sasha.
When we arrived at the hospital, there was a woman with her son and their Golden Retriever. While waiting for Sasha, the lady asked us if we have been at it (fighting cancer) for a while. We told her that Sasha has Osteosarcoma. We mentioned that her right arm was amputated, and now she was receiving her first chemo treatment. I asked her about her dog Chelsea, and the lady explained that she has some type of cancer, but after two biopsies, the doctors were still not sure what kind. She was only able to tell us that the cancer was in her gastric system. Chelsea is 10 years old. We hope that she has as long and happy life like her sister who lived an astounding 18 years.
As my eyes start to get watery from hearing the news about Chelsea, the nurse brings Sasha out. She was wearing a red bandana that says, “Hug Me. I got Chemo today.”
She comes out with a huge smile, which we did not expect, and when she sees us, her grin gets bigger. Sasha notices Chelsea and goes to smell her. Normally Sasha doesn’t care about other dogs, but it seemed to me that she spent several more seconds with this girl than with other dogs. Maybe it was her way of saying its OK – don’t be scared. I hope so. We wished them the best of luck, thanked the techs and people at the desk, and headed out, Sasha leading the way, and pulling hard.
Still not believing how happy Sasha was -with her red bandana making her look, oh so pretty- we got her in the Jeep. What is the first thing she does? She hops from the rear seat and puts her left front paw on the center console between the driver’s and passenger’s seats! This is amazing to Carlos and me, because it’s the first time in over a month that she’s done it. She has always been our navigator. And there she is again, on top of the console ready to go home and happy as can be. We keep trying to coax her to get back, but she won’t budge. We are thrilled that she feels as good as she does, and wants to stand on the center console to help Carlos navigate his way home = ) However, after we start driving, Sasha does end up getting back, because it’s difficult for her to keep her balance when Carlos applies the brakes.
On our way home, we drove with the windows down, and Sasha enjoyed taking in the smells, and feeling the wind. Before going home, we need to take her somewhere to get some hugs. We also needed to get dog food, so we stopped at Phydeaux. We walked around the store for a little while. We let Sasha go anywhere she wanted in the store, and she seemed particularly interested in the section with pig ears, tendons, and other similar treats. Three people saw Sasha hopping around, looking cute in her red bandana. They came over to say hi and pay compliments to Sasha. We didn’t want her to overexert herself, so Carlos went to grab the bags of food, we paid and headed home.
Upon getting home, Sasha is greeted by the pack, and they so want to give her some sniffing attention. Sasha heads outside to relieve herself, and then she plops on her bed to chill. It isn’t until about an hour later that we noticed Sasha seemed so tired that she even looked drowsy. We quickly realized that she was having the lethargy side effect the oncology nurse told us about. It was sad seeing her feel so sluggish, especially after how perked up she was earlier in the day. Thankfully, the lethargy just lasted Thursday night.
Even tough Sasha looked good in Pink, the bandages had to come off.
On March 21st, seven days after the surgery, Dr. N. removed Sasha’s bandages and checked the incision; it looked great. He and the rest of the staff said Dr. Clary, the surgeon, did a great job and they all seemed really surprised at how well and how quickly Sasha has been healing.
Then on March 28th, the staples come off. It was quick and painless, and yes, I do have the staples = )
On our way home from the vet, we stopped at our neighborhood park. We wondered if Sasha would be up for a short walk, and indeed she was.
We got this great shot. I say “we,” but really, it was Carlos who took the shot = )
Sasha
After the visiting the vet and the trip to the park, Sasha wanted to get on the sofa, and I let her.
Sasha on comfy sofa
I love to cuddle with the dogs, but when we purchased this sofa a few years ago, we decided to keep them off to keep the sofa clean. Now that Sasha has been getting special treatment, it has created a ripple effect. To be “fair,” I let a dog at a time get some time on the sofa. Of course at night, one of them sneaks into the room and up the sofa he/she gos. With so many, I feel its best to not let them all get on…otherwise, the sofa would not last long = )
On Thursday, March 15th, we brought Sasha home after her amputation. Even though I could not wait to bring her home, I was nervous and concerned. I didn’t want anything to go wrong.
Sasha’s first picture after getting home after surgery. Trying to find a comfortable position.
Leaving the vet’s office was not a problem, she didn’t seem to even need help; however, we used a towel as a harness to help her walk, then Carlos went in the back of the Jeep with her. We live less than 2 miles from the hospital, so it was a short ride. Sasha was definitely happy to be home, and the rest of the pack could not wait to see her, but we didn’t allow them to check out her immediately. We had arranged the living room for her and we barricaded part of it for the other dogs to not get too close too fast, though they instinctively knew to take it easy.
After she settled, she started showing discomfort, and she did something she has never done before. She whimpered. And although it pained us to hear cry, it was cute:
The first night was very tough, on everyone. Carlos and I both stayed with Sasha in the living room. Neither of us wanted to sleep on our bed and leave her alone, crying and in pain and confused about what was going on. Having her up on the bed was not an option; we could not risk her getting hurt. Sasha was in a lot of pain through the night. She could not sleep, and would often try to get herself in comfortable positions, but no position was comfortable. We gave her the pain meds as instructed, but even after a while the pills had taken effect, she would continue to whimper and this was breaking our hearts.
Carlos laid on floor cushions with Sasha’s head in his arms for most of the night. I slept next to them on the dog bed, petting her, trying to make her feel better. Sasha cried most of the night, but she also seemed to have moments of comfort, and she would fall asleep for very short periods of time. Through the night, when she’d awake and show interest in getting up, we would take her outside, and each time she seemed to feel better after coming back inside. However, most of the night she was in a lot of pain and even though petting her and holding her seem to make her feel better, the pain didn’t seem to diminish. We ended up calling the emergency hospital a couple of times to see if we could give Sasha extra meds, or give her the pills ahead of schedule. Thankfully we were told that we could. After giving her the medication ahead of schedule, out girl didn’t seem to be doing any better, so I called the clinic again. This time, I was told that Sasha might be having disphoria from the pain medication. We were asked to hold off on any more meds until the next scheduled dose, and to call our vet’s office in the morning. This is not what we wanted to hear. How could we let our baby suffer in pain? Seeing her in so much pain, with those sad eyes, now knowing or understanding what this was happening made us both question if we had made the right decision in amputating her arm. Sasha has always been healthy, and at the ripe age of eleven years old, she is a happy, spunky girl who loves hiking, swimming, and catching Frisbees. Our decision had to be the right one; we just had to get through these first few days to justly realize it.
The following morning, because I had only slept two hours, I skipped class and prepared some breakfast for me and Carlos. We fed the pack, and to our surprise, Sasha had an appetite! (This girl doesn’t seem to lose interest in food, just like her dad, lol.) I had purchased soft canned food because Christina, a vet tech at the hospital, hand fed her soft food while Sasha was there. So it was special for her to eat this food, and she loved it.
Stay tuned for more updates on Sasha’s recuperation.
Sasha has continued to improve. She gets around just fine now, and is even able to jump up onto, and down from the sofa. The pain around the surgery site is minimal. She often chooses to lay on her right side now, and Liliana and I are able to pet her near, and even on the healing incision. We are getting ready take Sasha in to get her staples removed. I’ll make a 2nd part to this post in a few hours to let you all know how she does at the vet’s.
It’s been a while since I wrote a post. As you know, our girl Sasha was not doing well. All I could think off was how the news of Sasha having cancer changes many things. Not only have I been distraught about the news, but I’ve been trying to focus on our next steps, looking back at good memories and planning to creating as many more as we can, knowing our time with our baby is limited, breaks my heart and slows me down. However, I’m doing my best to change this attitude as I know its detrimental, and staying positive through it all is the best possible thing I could do. Sasha has recovered well from the surgery. I will soon share more with you.
This post is about how quickly plans can change. Just a couple of months ago I was thinking I would have a job by now, so I was making plans about some things that we need to take care of. As you may recall from the lists post, we have a lot of things to do. But out of everything on and off that list, there are four things Carlos and I wanted to do as soon as either or both of us found a job.
The four plans were:
Increase our emergency fund to cover at least 6 months of living expenses.
Save 10% of every paycheck for retirement, or more if can.
Tommy’s surgery – our boy will need TPLO surgery on his rear left leg. Hopefully, real soon, we can do this for him.
Life insurance. Although we would have insurance through a job, we want to buy other policies to ensure our dogs will be taken care of if something were to happen to the both of us.
Though most of our plans are on hold, for the time being, there are a few small home projects we’ll be tackling. I’ll be sure to update you all on these as we get them done.
I’m sorry for not having posted in a while, as you all know, it has been been a rough couple of weeks. Since I have shared Sasha’s health situation, I thought I’d share a video with you.
Sasha, the day of her surgery, on our way to Dr.N’s office:
