Chemotherapy Beads

Brisbane just arrived home after a second surgery for his maxillary osteosarcoma, and he is the happiest dog! The tumor had been growing since shortly after his first operation. It had again gotten large enough to detract from his quality of life. We had a very scary incident on Memorial Day when he began bleeding profusely from his nose, mouth, and eye. His energy level had also gone down quite a bit over the last couple of weeks, and I was starting to fear that he would be ready to go soon.

Four day post-op and feeling good!

My amazing veterinarian had been researching new treatments for bone cancer, and found information on implantable biodegradable chemotherapy beads. These little beads emit chemotherapy drugs for several weeks after being implanted, and then they dissolve. They are used to treat cancer right at the site, instead of putting the drugs through the dog's whole system with oral or intra-venous chemotherapy. This allows a lot more of the cancer-fighting substance into the exact location of the cancer itself.

By the time we got the beads a week ago, Brisbane had been having frequent nosebleeds. He had also been bleeding from his mouth. His spirits were down, and I was genuinely concerned that he might not survive another surgery. I had to make the choice to either let him go, or put him through a risky surgery to give him a chance.

Well, I had nearly paid off the vet bill from Brisbane's first surgery in March, so obviously it was time to owe the vet some more. Brisbane stayed stable through the whole operation, and two days later was off and running. He came home four days after the surgery, and he's acting like a puppy again. Seriously, every time I turn around he's got something in his mouth. He's not allowed to chew anything yet, and somehow he's managed to find every food toy and chew that Sisci has lost in the last month.

This dog is the most amazing dog. He will be back to herding sheep and earning trick dog titles in a few weeks. If his tumor starts to grow again, we will do a small surgery to implant more chemo beads into it. The beads are hopefully more potent and longer-lasting than traditional chemotherapy treatments, and they're quite a bit cheaper too!

Six Months Later...

Six months ago I posted about finding a bump on Brisbane's cheek, and that I hoped it was just a tooth abscess and not something really horrific like bone cancer. That was my worst case scenario. A month later we had confirmed it was cancer, but the needle biopsy indicated it was likely a hemangiosarcoma, and slow-growing localized tumor. That type of tumor generally comes back more aggressively when removed incompletely, and the location meant there was no good way to remove all of it. The vet and I decided to let it be for a while, and I planned to make decisions later based on Brisbane's quality of life.

A little over a month after that, the tumor suddenly grew almost overnight. It interfered with Brisbane's teeth, he kept biting it and bleeding. A lot. I called the vet in tears and brought him in the next day, thinking it was the end. I told the universe over and over that I would do anything to have more time with him.

Brisbane was still in shockingly good spirits, rolling in the grass, sunbathing, chasing squirrels, herding sheep. I had even taken him to his first ever Barn Hunt class the day before his condition deteriorated, and he was so intensely focused and excited to play. I asked the vet about palliative surgery, just to keep him happy. She agreed, seeing how cheerful he was despite the huge tumor in his mouth.

I had been saving for our big move out of California, and to start my own business. To pay for Brisbane's cancer treatment, I ended up draining my savings account, starting a GoFundMe campaign, and ultimately making payments to my amazing vet. Brisbane recovered from surgery remarkably well.

We sent his whole giant nasty tumor off to the lab to find out what exactly it was. The results came back: osteosarcoma. Bone cancer. The worst possible thing.

Except...it wasn't the worst thing. It was just a thing. It was more information about what we were already dealing with as gracefully as possible. The thing about bone cancer is that it's a fairly common dog cancer, and humans get it too. This means there's quite a bit of research and some different treatments available. The type of tumor we thought it was, a hemangiosarcoma, doesn't respond very well to chemotherapy. Osteosarcoma does respond well to chemotherapy.

The most common type of bone cancer in dogs occurs in the limbs. This cancer tends to strike young, large-breed dogs, and rapidly spreads to the lungs in most cases. Often the cancer has already metastasized by the time it is detected. Osteosarcoma in the upper or lower jaw, like Brisbane has, is a bit less common and tends to run a different course. These tumors tend to be locally invasive, but unlikely to spread to other parts of the body. They also tend to be less painful than bone tumors in the limbs, and some are not painful at all.

I had thought that a diagnosis of bone cancer meant horrible pain and suffering followed by euthanasia far too soon. It turns out that osteosarcoma is not the same for every dog. We originally ruled out bone cancer simply because Brisbane was so darned happy and clearly not in unspeakable pain.

In the three months following his surgery, Brisbane's tumor has regrown quite a bit. Most of the swelling is actually blood rather than tumor, but when drained the thing just refills. He has been extremely happy and active up until the last week. Fortunately, our amazing vet has been doing lots of research and has acquired some chemotherapy beads. Tomorrow, Brisbane will be having a second surgery to debulk the tumor again, only this time the doctor will also implant several of the chemo beads at the site. These release chemotherapy drugs right at the site of the tumor itself, rather than putting them through his whole system via oral or IV drugs.

Just when I nearly had his vet bill paid off, I'm about to throw everything I've got into keeping my dog happy, again. I am extremely fortunate to be staying with my parents for the moment, allowing me to throw nearly everything I make into Brisbane's cancer treatment. I've put off my dreams of business ownership and moving for a year, and every time I look at my happy dog I think about how he is so totally worth it. When he stops being happy, I'll know it's time to let him go. For now, I'm taking him with me to both of my jobs and enjoying spending almost every hour of every day with him. I don't know how much time he has left, but even it's short I think this is a lovely way to spend it.

Finally Home!

After staying an extra night at the vet for IV pain meds, Brisbane finally came home on Friday. He had surgery on Sunday to remove the tumor that I first noticed in December. It was much larger than we thought on the inside, and he is recovering extremely well after such a major procedure.

Before med time, we went for a short stroll outside. Brisbane was very happy to be outside, he stood there sniffing the breeze for the longest time before happily trotting down the sidewalk. He even gave me a classic Briz grin.

The vet did one more big dose of IV pain medication before we left, so Brisbane came home very groggy. As soon as we got home, he flopped on the bed and fell asleep. This morning we will begin oral pain meds and figure out what it takes to keep him company.

Brisbane had been at the vet for a week, I dropped him off on Friday of last week for a couple of days of pre-op care before the surgery on Sunday. Sisci was very happy to see him today. Ru...was confused. Also a bit growly. I think he might have forgotten about Brisbane entirely. He has a tiny brain, it might only take him a week to forget things.

If I had known ahead of time that the tumor was so extensive, I might have made a different choice. I'm glad I didn't know, so far I have absolutely no regrets about this surgery. Briz has handled everything beautifully, and I'm sure soon he will feel so good that I'll have to hold him back from doing too much. Cattledogs are all about overdoing it.

Brisbane's GodFundMe campaign is still active, and we would love as many social media shares as we can get. Costs are running higher than initially expected because the surgery was significantly more involved. He's worth it though. So, so very worth it.

Next week we should have a pathology report on the mass, and hopefully our amazing vet will be able to do a case study to help other dogs with hemangioperisarcomas.

Two Days Post-Op!

Yesterday was Day 2 of recovery after Brisbane's big surgery, and he is starting to feel a bit more like himself. He is perky is enough to get grumpy with the vet for messing with the IV catheter in his leg, but doesn't mind having his face cleaned. Since the mass extended into his nasal cavity, the surgical sight can drain through his nose and he doesn't need an icky surgical drain in his head. The surgery was done through his mouth, so he won't have any scars on his face.

The pain meds are really good, you guys.

Poor Briz is still lumpy and swollen after his facelift, but his cheek is already much closer to normal than it was before surgery. He had 200 cubic centimeters of mass removed, and we're not quite sure what he'll look like when fully recovered. His jowls are still quite puffy, but the swelling has improved dramatically since yesterday and should continue to get better rapidly.

The most exciting news today is that Brisbane is tracking objects with his left eye. The pressure from the tumor had reduced the function of that eye significantly, and before surgery we couldn't be sure he could see at all with it. The assumption was that he had lost vision entirely on that side, and we were not expecting it to return.

How is he feeling? Not so great yet. We went for a tiny walk outside when I went to visit him today, and then he was ready for a long nap. I was relieved to see that he was resting comfortably and sleeping peacefully. His kennel at the veterinary hospital is usually left open, and he has been getting up and exploring a bit today.

I was hoping to bring him home yesterday, but Briz still needs injectable pain meds to stay comfortable. Today the vet is starting him on oral pain medication to see how he does, and if he continues to improve he can come home tomorrow.

Brisbane has not recovered his normally spectacular appetite yet, which is incredible. He did eat a tiny bite of Fromm Shredded Pork for me, but I'm sure his mouth is still very sore. He'll be eating soft foods for a while, so we'll be checking out some new squishy foods during his recovery. I'm not too worried about him eating yet, he was a couple of pounds heavier than normal before the surgery so he's got a little extra padding in there.

Please share Brisbane's GoFundMe campaign if you can. Our amazing vet has used a number of different treatments to help slow down the spread of the hemagiopericytoma, and we're hoping she will be able to write up a case study to help other vet treating dogs with this type of tumor. Though this was not a curative surgery, we're hoping this palliative treatment will get Brisbane a lot closer to the end of his expected cancer-free lifespan. There is also a fund set up for direct donations at Valley Animal Hospital in Goleta, California.

Post-Op Report

Brisbane's surgery took place on Sunday afternoon, it went very well and he is currently at the vet hospital being monitored. Hopefully he will be able to come home tomorrow if his pain is under control and he is healing up well.

The size of the mass really surprised everyone, it was so big it actually outgrew its own blood supply and the tissue at the center was dead. The bump visible on his cheek was only a very small portion of the tumor, it actually extended well into his mouth and sinus cavity, and up past his eye socket. It may have been growing long before I noticed it in December. It had actually eaten away the jawbone around his back three teeth.

Hemangiopericytomas are nearly impossible to remove in their entirety without amputating a limb. These tumors tend to grow tendrils that wrap around everything, and it can be extremely difficult to get good surgical margins without sacrificing a lot of healthy tissue. Since this was a palliative surgery rather than a curative procedure, the vet chose to preserve as much healthy tissue as possible. Cryosurgery was done on the parts of the tumor that were not removed in order to slow their regrowth.

Brisbane lost three teeth, but did not lose his left eye. He may not have control of his facial muscles on that side when he recovers, and we don't think he has been able to see out of that eye for weeks, possibly months. The vision in that eye is not expected to return.

Recovery is going to primarily involve pain control, and prevention of infection. At the vet hospital, Brisbane currently has a pain patch as well as IV medication to keep him comfortable. Tomorrow he will be started on oral pain meds to see if those will be enough once he comes home.

Dr. Rugg is truly amazed at how active and happy Brisbane has been with this huge mass in his head. He had been herding sheep and lure coursing with tremendous enthusiasm as recently as a week or two ago, and remained as gregarious as ever up until the surgery this afternoon. I am sure he will be feeling much, much better soon. So happy he's on the road to recovery!

Icky Nasty Tumor Pictures

Brisbane is spending an extra day getting IV drugs before surgery, which has been postponed till Sunday morning. This is mostly because our amazing vet team is making sure they have absolutely everything on hand that could be useful, including cryotherapy equipment for freezing things. We are also waiting to hear back from the veterinary oncologist who has been advising Brisbane's doctor and may be aware of some as-yet-unpublished experimental treatments that might be helpful.

This is what it looks like on the outside.

In the meantime, Brisbane is on antibiotics and has been started on some powerful pain control that should keep him comfortable in the early days of his recovery. He's content to just chill with the team while we make sure everything is in place for the big event.

In his very relaxed state, Briz allowed the vet to get a really clear picture of the part of the tumor in his mouth. It's super gross and I recommend not scrolling down if you don't like yucky medical pictures. I was unable to get such a good view of it, and frankly it's a lot worse than I thought. So, so very gross.