Having a pet is a long term commitment. At some point you have to deal with the reality that pets don't live forever. However, neither should they be viewed as disposable when a health issue crops up. This is why we are trying to do what we can for Linus and treat his melanoma so he can live his life fully.
As I stated before, we decided to take Linus to the Missouri University Veterinary School in Columbia, Mo. Per their website, the visit was just what we expected. Jen Wolf, Senior Level Student came out to the waiting room to take a history on Linus. Then when they were ready we took Linus to an exam room and Jen checked him out from head to tail. After that, she went to get Dr. Alix Partnow and review the history with her. Dr. Partnow came in and she examined Linus herself, and went through all of our possible options, explaining things as she went and as we asked questions. What they needed to do before anything was to "stage" his tumor, meaning they needed to know if it had spread anywhere else or if he had any other type of masses or health issues. The meant we had to leave Linus there for a few hours while they ran blood tests, aspirated his lymph glands, xrayed and ultrasounded his body (they shaved his belly!) and performed a urinalysis.
We were told to return at 5:15pm to pick him up, however we got a call at 4pm telling us they were done and no other masses or issues had been found! Good news! So we headed back to the hospital to get him and figure out what to do.
Jen Wolf, Dr. Partnow and Dr. Sandra Axiak, the oncologist, all met us in the exam room to discuss the choices for dealing with the tumor. It was news to us that the bulge he still has on his gum line is a tumor. It grew back that fast and I do not think the Vet in Sullivan was aware of this. In fact, I'm sorry we put him through that first surgery because I do not think it did any good other than giving him a tiny bit of relief for only a week.
Basically, the choices now are:
--Do nothing and watch the mass on his gum continue to grow until it affects his eating, metastasizes, and impacts his life.
--Enter him in the Clinical Trial NHS-IL12-IL2 or NHS-IL12 Immunotherapy for canine melanoma.
--Treatment with the human DNA (tyrosine) based melanoma vaccine.
--Surgically remove the tumor and surrounding tissue and bone in hopes of getting all the tumor cells out. Radiate the area for 4 to 6 weeks.
--Debulk and laser the tumor and surrounding tissue and bone. Radiate the area for 4 to 6 weeks.
We decided to try the clinical trial for several reasons;
#1 It's least invasive, although not entirely pleasant for Linus.
#2 The entire cost of that treatment is covered by the study.
#3 We can turn to the other solutions if it doesn't work within 3 weeks.
#4 Linus has a chance to leave a legacy of contributing to science and a cure.
#5 Linus's tumor tissue sample will become part of a tissue bank regardless of success. Canine Comparative Oncology and Genomics Consortium (CCOGC)
#6 We just aren't ready to put him through surgery again so soon.
So here's what is in store for Linus (and us) over the next 5 weeks...
Week#1 - Drop Linus off at the hospital on Sunday, July 26th. On Monday they will shave his neck and insert a "port" for blood draws. He will then be given either NHS-IL12-IL2 or NHS-IL12 and then his temperature and blood will be monitored according to a schedule over the next 2 days while he is in doggy ICU. We will pick him up midday on Wednesday and we will need to take his temperature daily for five days and report it on a special form. We can expect him to be lethargic and not quite himself due to the immune system response.
Week#2 - The following Monday, Linus will need to be brought in for more bloodwork, fine needle aspiration of the lymph glands, and biopsy of the tumor. The tumor size will also be measured to see if there is any response to the immunotherapy.
Week#3 - Repeat of week#2. If there is response we continue. If not we stop the trial and discuss other options for treatment.
Week#4 - Repeat of week#3
Week#5 - Repeat of week#4 and evaluate 28 day regimen.
So, this is the plan for now. I know some people wonder if we are putting him through too much but honestly he still gets excited to get in the car even though his last 3 trips were to be poked and prodded. That tells me he has no lingering effects from his medical treatments.
Last night we came home to find our chain link fence completely installed! We put both dogs out there and even got Linus running around and chasing the tennis ball a little bit. So he's all about living in the moment and we're all about making sure he has as many moments as possible.