I know it has been way to freaking long since I have blogged. Work and life have been crazy, and my focus has been shifted elsewhere lately.
Spring has finally arrived in Caratunk.
Very soon I will again be writing about the long rides, runs, and swims that I do for fun in the big city. No Ironman this year, I am actually pretty light on the racing this year – but I have plans for some good, long, endurance adventures that I can’t wait to share.
I am even buying a new bike! Bike porn coming soon!
For the moment though, something different has my complete attention.
Many of you know this, maybe some don’t – Porter has Mast Cell cancer.
His 3rd birthday is June 14. Yes. That is really young. I have done the kicking screaming over this more than a few times.
When I first found out about this, I was lost in a haze of Google searches, medical terms, and fear of what might happen to my buddy.
The short version is that Porter is going through chemotherapy right now to fight this cancer.
The how’s and why’s are below – this is a long entry but feel I need to get this out there. I would have loved to read a story of someone else who went through this in my search for options, so I hope that by sharing our experience, it might help someone else.
How it started…
Back in mid-February, I noticed a little lump smaller than a pea on Porter’s right ear. It looked kind of like a simple sebaceous cyst (Bailey used to get those often). Within a few weeks though, it developed a more wart-like appearance and started growing. It became really gross really fast – within a week it went from a unsuspicious looking pea to a dime sized scary thing.
My vet took one look at his ear and said, “Let’s aspirate that.”
And so we did. She walked back into the room with this funny look on her face. I didn’t ask her anything, because I assumed nothing serious could be wrong. We just spent the winter working in the woods together; my boy was in tip-top shape.
But she said, “If it is OK, I would like to send this into an oncologist to be 100% sure of what it is, I see some…cells in there that seem suspicious. An oncologist can tell with certainty if it is a benign cyst or a type of cancer.”
Porter having cancer was the last possible thing on my mind.
I nodded my head and hugged Porter. They said we would know Friday or Monday.
Mast Cell Cancer
Early Friday afternoon, I called the Veterinarian’s office hoping for some results from the test. The woman who answered the phone said, ”Ah… Hi Mandy. Dr. Keene would like to discuss the results with you. What is the best number for her to reach you at?”
Crap. That means it is bad news. They can just give you good news.
I paced a hole in the floor waiting for that phone call back.
My vet called me back later that night, she sadly told me Porter has Mast Cell cancer, which she suspected that it was pretty aggressive and high stage but couldn’t be sure until the tissue was tested further.
She patiently talked me through what the cancer was, and then told me there was…more I needed to know. The first step in treatment is surgery, and with this particular cancer the best way to get clean margins is to – cut off the ear above the tumor, at which point it could be sent to a lab for staging.
The surgery was scheduled for the following week. That night I fell asleep googling “Mast Cell Cancer” and learning the one thing I didn’t want was Stage 3 because it seemed to have a pretty poor prognosis.
The worst thing I ever saw was my sweet boy happily walking down the hallway wagging his cute little stub tail to go into surgery. My heart imploded as he walked away.
The vet asked me aesthetically what I wanted with his ear, and I said, “Aesthetics?? I want the cancer gone. Do what you have to do to get clean margins.”
I had in my head that it was Stage 1 cancer, and this surgery would get rid of it. Once he healed up we could just get on with our normal lives.
Surgery was successful – the lower part of his ear was removed with laser surgery. We found out later that the margins were clean – great news.
He came out with the cone of shame on his head, looking completely confused but happy to see me. All I could do was hold him and hope the cancer was low stage.
The staging results took about a week to get back.
By now, Dr. Keene and I were getting to know each other pretty well. I could tell she had her “bad news voice” on. I braced myself.
The cancer was Stage 3.
I couldn’t hold back the tears. How on earth could this be? It was there for 2 months, tops.
She told me the next step was to see whether or not it was in the lymphnodes, and that once we see what we are dealing with, we could decide what to do. She mentioned chemotherapy as an option.
Chemotherapy???? Pictures of my grandfather and my sister-in-law and my friends who had been through it flashed though my head.
No. No. No.
So, I went back to Google. Everything I learned online was horror stories about stage 3 Mast Cell Cancer.
I asked the vet for copies of all the lab work to be emailed to me so I could see them. I wanted the details – I believe Doctors of all types tell people what they need to know, not sure they want the details or even would understand them.
Me, I wanted the details and figured I could teach myself to understand them.
And what I learned wasn’t encouraging. It was heartbreaking.
The Mitotic Index was 32 of 10 (this is the measurement of how quickly the cells are dividing, you want like, less than 5 of 10), there were a lot of big words that Google and I figured out boiled down to bad, nasty, aggressive, invasive cancer.
Crap. Crap. Crap.
This is when I decided that I was not going to focus on the cancer – I was just going to appreciate every moment I have with him and be thankful he is in my life.
Something we should do with everyone we love anyway.
Good News and Chemotherapy
We got some good news…finally. His lymphnodes were clear. X-rays showed no evidence of cancer in his body.
The issue is – with Stage 3…Cancer cells have likely been released into his body. We just can’t see them yet. Our options?
1) Gamble. Do nothing and hope it doesn’t show up in 3-6 months. The downside of this is if it shows up, by the time we notice it, it will most likely very advanced, severely limiting treatment options.
2) Chemotherapy. This should kill those cancer cells in his body – and also do all the bad things chemo does: affect rapidly dividing cells, suppress immune system, & cause nausea or diarrhea. They type of chemo is called Vinblastine, and it is 8 treatments – 4x every week, then 4x every other week.
Prognosis without chemotherapy isn’t good. With chemotherapy, it is much much better, with a chance of getting rid of the cancer and him having a normal life later.
With some prodding, I got a second opinion from an oncologist in Portland, 3 hours away. She said the same exact thing – except she suggested a much more aggressive type of chemo that would require 6 months of treatment.
I felt like she would have started treatment that day if I would have agreed to it.
I left there feeling judged. As if I wasted time trying to decide what to do (from his surgery to this point was 2 weeks, and one of those weeks were waiting for grading results, so I wasn’t exactly dragging my feet).
I knew I was doing the best I could, but this was like a kick in the gut to me. I walked out of there feeling anxious, in a hurry to do…something…feeling like I had failed Porter…and was even more confused about what really was best for him.
I wanted to go running back to Veazie Vet – who didn’t judge me at all, they kindly gave me my options and the time and space to think about them. I scheduled his first chemo treatment, going with Dr. Keene’s suggested Vinblastine protocol.
First Chemo Treatment 4/30/14
I was a mess.
Porter and I did some work in the woods before his treatment, putting in some boundary lines for a landowner that lived fairly close to the vet’s office. The whole time I was thinking of pulling the plug. I hated the idea of chemo for him, of him possibly being sick.
But I hated even more the idea of doing nothing and wishing I had.
When I got to the clinic, Dr. Keene was waiting for me. She sat with me and we talked about more test results that had come in (more not great news) and we talked about my experience in Portland and about what Porter’s chemo would consist of.
She spent a good 30 minutes with me, and that time was much appreciated. I felt like I was doing the best I could for Porter, and knew that he was in the best possible hands with her.
He had some blood tests taken, and then it was time for him to go in for his first treatment. I hugged him and held back tears as he wiggled his little tail into the chemo room. I sat and impatiently waited for him.
It took about 20 minutes and he was back out, his happy little self.
Effects of Chemo
So far – Porter is his normal sweet, friendly, happy self – we are about a week out from his first chemo treatment. He is a little more tired than normal and a bit fussy eating.
The vet gave us Cerina for nausea for the first few days, and I have him on Fish oil (Omega-3’s), Turkey Tail Mushrooms, and probiotics daily. I have changed his diet to Evo, a very low carb high protein food.
I am not sure what to expect from the future, but I hope that this continues. I plan on updating his progress weekly in hopes that this helps anyone else facing something similar.
One last thing – I want to thank all of my friends and family for their tremendous support, gifts, love, and kind words. On Facebook, Twitter, and Instagram I was overwhelmed with the response and the many #PrayersforPorter. Thank you Thank you Thank you. A million times thank you.
In addition to all of that goodness- I found tremendous support and insight from the Bernese Mountain Dog community through various Facebook Pages, Yahoo Groups, Porter’s breeders (the 2 different owners of his Mom and Dad). I do not have enough words of gratitude to everyone. Thank you Thank you Thank you.
I am by no means an expert, I am just a girl who loves her dog. This is all my interpretation of what I have read and been told by veterinarians, books, articles, and veterinary websites. Please consult your veterinarian on any and all health issues with your 4-legged friend.