In Memory of Linus

One year ago on this day we said goodbye to our dear dog, Linus. The end of 13 years of memories of our "play dog", Linusaurus Rex. It's been really hard not having his little personality around anymore. I can't believe it's been a year. It still seems like just a few months ago.

How he came to be our dog...

It was a year or more after my childhood dog, Honey had passed away that Linus came to us. He was a stray that had "shown up" at my parents home in Gerald, Mo. Dad called and said he had a dog for us, so we drove out to take a look. He was about 5 or 6 months old, lanky, and a bit under the weather. He had a very expressive little face and we loved him immediately.

He rode on Darrin's lap all the way home, a bit lethargic but still cute.

We took him to the vet ASAP and got him all fixed up, wormed, shots, neutering, etc.

That "puppy stage" was so trying! He had a penchant for chewing plastic. CD cases, cheap shoes, one of every pair of my dress heels! Oh, and how dare the mailman bang on our mailbox every day! Yep, Linus busted out the front window glass one day prompting a stern letter from the USPS about controlling our dog. We promptly replaced the 50 year old windows.

He loved to chase a toy down the hallway, and walks were a favorite although we regret not taking him as much as we should have. Tennis balls were the only toy that survived his attentions. He loved the soft, stuffed, squeaky toys...but a little too much as it only took a few minutes of play for the stuffing to suddenly appear on the outside of the toy.





The Melanoma...

In 2008 I took him to the vet for an abscessed tooth. They put him under and did a good cleaning and ended up removing 3 teeth! Then in June of 2009 it appeared that he had another abscessed tooth. However, when they took a look it turned out to be a tumor. On June 30th it was removed and we had it sent off. The news was not good, Melanoma which in dogs is terminal, he had 2 to 6 months at best. We looked into several options and finally took him to The University of Missouri - Columbia. They did a full workup and approved him for a clinical trial of Interleukin. Wasting no time we brought him back the following week, they treated him with the trial meds and after 2 days sent him home. He promptly spiked a fever which resulted in a midnight run to our local vet for an IV, then an early morning ride back to Columbia. It was almost two weeks of the staff trying various treatments to get his platelets to normalize...they never did. I was amazed at the extent of the treatments but in the end Melanoma, or rather a complication called DIC due to Melanoma that had metatasticized was the final straw and we were forced into making the decision to let him go. It was one of the saddest times in my life.

Closure...

About 2 weeks after we said goodbye, we received the package from Columbia. It had his collar, paw imprint, and a card signed by all the caregivers, veterinarians, and vet techs. I opened the box in the kitchen by myself and cried my eyes out. Darrin came in from outside and I showed him what came and we cried together.



About a month or so after, we got a call regarding his Melanoma. They confirmed that it had metasticized to his lungs. There was really no way for him to survive. We did the best thing we could do, we gave him a chance, contributed to science through our participation in the trial, donated his tissue for the tissue bank, and allowed a necropsy...that's more than a lot of dogs get to contribute and we can feel good about that even while we miss him every day.

Rest in Peace, Linus.

Phone Call From MUVTH

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Originally uploaded by dehmystic

Today at lunch my cell phone rang and the caller ID said Mizzou Vet Hospital...my heart caught in my throat. Even though I know Linus is gone seeing that ID pop up just brought back the anxious feelings I'd get when they would call with an update.

I answered it and it was Dr. Selting. She wanted to go over the final report on Linus. Since we were at lunch with coworkers I opted to call her back. Of course then that's all I could think about so as soon as we got back I put in a return call, hoping to reach her.

Luckily I was able to reach her and find out why Linus did not make it.

First off she said he had a lot of abnormality in his tissues. Primarily the cause of his decline was something called D.I.C. or disseminated intravascular coagulation. Basically, it’s a clotting problem that leads to the formation of small clots throughout the body. These clots then pull any remaining clotting factors from the blood and cause bleeding problems. She mentioned that the blood sample pulled just before we euthanized would not clot. D.I.C. is secondary to other causes, meaning it occurs when other problems are present, like cancer.

Also discovered were some small metastases in his lungs. These were too small to be seen on an x-ray and it's not clear whether the IL-12 treatment would have affected these or not. In Dr. Selting's opinion, the presence of these shows he would have succumbed to cancer eventually.

Another odd finding was belly muscle damage. It was not consistent with trauma or bruising but may be associated with the D.I.C.

No brain metastasis was found. So the neurological problems he initially had were not related to any cancer there.

Tests showed the pneumonia was resolving, there was no trace of bacteria.

Tests on his spleen and bone marrow both showed that his body was trying to produce the necessary blood components. Dr. Selting thinks this is why we saw some improvement, then when the D.I.C. got too bad those organs could not compensate enough.

There is still no firm explanation for the excessive edema but it too could be part of the capillary leak and/or D.I.C.

All in all, while we were hoping for a cure or a reprieve, the truth is he showed many signs that the situation was not going to improve and the pathology information just proves that.

Euthanizing him was the best choice we could make at the time as there was no way to combat all the problems in his little body. At least we don't have to feel like we gave up on him. It's also better to know that his cancer had metasticized because we agonized over not just choosing surgery when truthfully that would not have helped in as much of a way as we would have expected it to given the spread.

Processing all of this has reopened the pain of our loss. I think that's normal, and I know that we'll get a point where we aren't as weepy when we think about it. There's no time limit on grief, is there?

In the mail today...

A wonderful and touching card with notes from the staff, his pawprint and his collar.

I should also mention that several of our friends and family sent us sympathy cards which we really appreciated.

Thursday - Day 11 *updated*

Lorie called this morning and said Linus finished the albumin and so far so good. It could take 24 hours for the edema to resolve. Dr. Selting had him up and out of his cage this morning, going outside and then walking him through the halls. Lorie said he was greeting all the other dogs and when they got back to ICU he went to each of the other cages as if to say "hey, what are you in for?". She said she only has one case today so she'll have a lot of free time to walk him around and massage his extremities to help get the fluid moving. We're planning to go up on Friday afternoon and stay the weekend.

**3pm call from Lorie**
Lorie called with the same story, good news and bad news...

Linus's HCT is up to 20,000 and his platelets are up to 100,000. He's walking and interested in other dogs around the hospital. His neurological symptoms have resolved! Unfortunately, the fluid has moved into his lungs so he now has pneumonia! He had some labored breathing so they tapped his lungs and pulled out the fluid to give him some relief. He's on nebulization every 4 hours and they've lowered his regular fluids via IV and added two antibiotics. They are running another kidney profile and may end up infusing him with another dose of albumin. When will this dog catch a break?!!?

Wednesday - Day 10 *updated*

Lorie called this morning but we were driving in a signal free zone so we just got a voicemail. It said that Linus still had fluid around his lungs and had some labored breathing. She was going to consult with Dr. Selting about the next steps for Linus.

Dr. Selting called this afternoon to report that Linus's platelets were up to 69000 and his HCT was at 18000 last night but down to 15000 this morning. His kidney function tests were slightly improved. They were able to put the jugular catheter back in place with no problems.

She said he had lots of swelling this morning but that is was a bit better now although still swelling in his front legs and around and under his chest. So after consulting with the critical care staff they've decided to try to infuse some human albumin which will do a better job than Hetastarch at drawing fluid out of his tissues and into the bloodstream. Unfortunately there is a chance for allergic reaction again so they are giving him Benadryl and infusing very slowly over the next 6 to 12 hours.

We are trying to stay optimistic but its really hard considering the decline of his health and all the things that are being tried on him. We can't say for sure whether it was the Interleukin, the fever, or his body's reaction that caused his decline.

Our other dog, Baby, is beginning to appear depressed. I tried to play with her last night a little but she was only interested for a bit then she headed to her bed in our bedroom and stayed there for the night. Usually she's out in the living room a couple of times pestering us for petting or water or going outside. Is she sensing our feelings or does she miss Linus?

***4pm Update from Lorie***

Lorie called to give us a quick update. Linus has been receiving the human albumin for 4 hours and has not had a reaction to it. That is good news. They gave him Benadryl and he is still on corticosteroids so hopefully those will keep his immune system from reacting. The infusion will take 6 to 12 hours total. She's going to give us a call this evening with another update before she leaves.

ICU staff are checking on him every few minutes to make sure he's handling the infusion okay. I feel that this step will either make or break his recovery. Human albumin can cause a severe reaction in dogs and can only be used one time because after use the dog develops antibodies and a second exposure is very likely to trigger anaphalactic shock. I think the Vet chose this as a last resort for addressing his worsening edema.

***7pm Update from Lorie***

Linus had a reaction to the albumin right when Lorie was calling us earlier. They stopped it for a bit then started it again more slowly and he's been fine ever since. They are feeding him 1/2 can of food every four hours and he is accepting it via syringe and keeping it down. She's left them strict instructions to make him walk out to the fenced area (no gurney) as he can be stubborn. They'll monitor him closely overnight for any issues.

Tuesday - Day 9 *updated*

It's been 9 days since Linus was treated with Interleukin. Our call this morning from Lorie said that he is getting more alert and he even picks his head up now when she comes in to get him. He's also happy to wander the yard and sniff at flowers and grass. His edema is still bad and they are considering increasing his steroids. His bloodwork showed his anemia is worse than yesterday so another transfusion may be in the works. Dr. Selting is calling NIH to see what other supportive care can be done to speed his recovery.

Yesterday, Dr. Selting indicated that NIH is very optomistic about Linus's recovery and that it will be 24 to 48 hours before things start turning around. I sure hope that is the case...


***3pm Update from Dr. Selting***

What's better:
He got up on his own when it was time to go out.
Reduced edema in right rear leg
HCT at 14000 up from 12000 this morning. (normal range 35800 to 60000)
Platelets at 52000 up from 26000 2 days ago (normal range 200000 to 500000)
Low pressure but improved from before.

What's worse:
Swelling (Edema) in front legs
Swelling in chest (not lungs so no distress).

What the plan is:
Increase Hetastarch
Increase steroids
Push food via syringe.

Possibilities: Remove leg vein cath and insert a jugular cath. This will faciliate blood draws and be less painful than leg cath at this point. Implement a feeding tube. Only done if he starts refusing syringe feeding or they can't get enough calories in him via syringe.


***7pm Update from Lorie***

Well no major breakthroughs...but Lorie said that everyone is pulling for Linus! Dr. Selting did put in an order to push the calories into him as much as possible. Lorie said that he has been lifting up his head for her and got up in his cage on his own twice today. They think that more activity and walking will help his edema so after he went outside today she walked him through the hallways, the long way around to ICU. She just wishes that his blood tests reflected the improvements in his energy level.

Lorie asked if we were able to visit again. I told her that we would consider it if we could come in the evening otherwise we couldn't come up until the weekend. She said not to let anything stop us and that she would be willing to come up in the evening if we felt like we needed to check on him. DH and I will talk about this and figure out when we can head up there.


***Important Tip....Take a video of your dog regularly! This way you can show the Vet what their normal behavior is like. Also, if you switch Vets, like we had to due to a rotation change the new Vet will have an idea of how your animal behaved prior to the onset of the injury or illness. The Vet and Vet student we are dealing with have no idea how lively Linus was when he came in because they were new to his case. I only have short videos of Linus on my phone and I so wish I had taken some better ones while he was out running in the yard.

Monday - Day 8

Interleukin 12 is Linus's kryptonite...

We got to visit Linus twice again today. He's still weak and wobbly. We brought Baby in to see him as well but didn;t get much response. They opted not to take a biopsy so we were able to feed him today, again via syringe. When he goes outside he tries to eat grass.

We did see him perk up when they brought a dog into the yard. He even tried to follow it!

Back inside he just chilled with us in the comfort room, but at least he was able to walk back to ICU on his own with a little prodding.

Visiting Linus in ICU - Day 7

Today we drove up to Columbia to visit Linus at MU. Our original plan was that we would stay overnight and take Linus to his Monday appointment. When it became apparent that Linus would be staying in ICU we decided to come up anyway and visit him. The Vet and Student both thought it would be beneficial for him. They said he seems really sad and still won't eat.

We brought Baby with us, checked in the hotel and got her settled then headed over to MU after the Vet Student, Lorie, called us. We got to go back to ICU where Linus was laying in his cage getting a blood transfusion. He's been anemic and they finally decided that he needed assistance. The theory is that the fever may have aggravated some stomach ulcers. They've been giving him Pepcid and also a pepto bismol type medicine as well as the anti nausea med. He still hasn't been eating so we brought an array of treats with us; hamburger, baby food, Beneful soft dog food. They opened his cage and let us comfort him. Darrin offered him a bit of hamburger but he didn't want it. I opened a jar of baby food, chicken puree yum yum, and the Vet suggested using a syringe. So she filled one up and pushed a little into Linus's mouth. He seemed to be able to eat it so I got down and fed him two more syringefuls, then he ate a couple of bits of hamburger! They suggested we leave it at that so as not to upset his stomach. They wanted him to finish the transfusion and we agreed to return 3 hours later to visit him again.

At 6:30pm we showed up and they brought him out from ICU and we walked him out to the fenced area. He was walking pretty well but still seemed weak and a bit disoriented. He was able to pee twice and then we got him back inside into a "comfort room". The comfort room had an area rug, two couches, a TV, and a hassock. We all filed in there to see if he would relax and eat more food.

I should mention that at our earlier visit we were asked if we would participate in a research project called Caring For Both Ends Of The Leash: Effects of Owners Visiting their Dogs in an Intensive Care Unit. Basically, the researchers take pulse and blood pressure as well as pain scores just before we visit, 5 minutes unto the visit, 20 minutes into the visit, then 5 minutes before the visit ends. Then we have to fill out a questionnaire. Of course we agreed since we are all about contributing to science! Plus it is interesting to know that visiting a pet in ICU may have a measurable and positive effect.

So the Vet, Vet Student, Researchers, us, and Linus all went into the comfort room. We got Linus to lie down on a a mat on the carpet and we petted him and offered him more hamburger. No such luck. So we got the syringe out and I fed him 3 or 4 syringes of pureed chicken baby food. He drank water and just kind of hung out. They left us alone with him and it was nice to just relax and observe him. He really is out of it. He would look at us or what we were doing but mostly he would just put his head down and rest. Hopefully, the transfusion and bit of food will help him perk up some more.

I guess we spent a little over an hour with him then they told us he needed to get back on his IV fluids. We got him up but when they tried to get him to walk back to ICU he got stubborn and flattened down to the ground refusing to go. So they had to carry him. We finished up our questionnaire and headed out.

Basically, he appears to just need some supportive care and will hopefully begin feeling much better soon. We are supposed to get a call in the morning. They're not sure if they will be able to complete the tests for the melanoma trial. They don't want to do anything to jeopardize his well being. Also the tests are quick, blood draws and needle biopsy; they would need to sedate him. We're hopeful that he will stabilize enough that we can bring him home for some TLC.

Improvement! Day 5

I emailed the clinical trial tech at MU for an update on Linus:

Dear MrsLacubrious,

I was just down in ICU looking at Linus, he seems to be doing much better today. His temp is down to 102.8, he is still ataxic, but not nearly as bad as yesterday. He pulled Lorie around this morning when she took him out for his walk. He did tolerate the rest of his plasma transfusion. I think that the worst is behind us. I will check with Dr. Selting when I see her this morning about repeating a CBC on him today to see if his platelets are rebounding yet.

He is sleeping like a baby now. I’m sure he’s exhausted he had a bad day yesterday.

I’ll keep you posted on how he’s doing.

DT



*******UPDATE FROM LORIE***********

Linus was alert and walking although still somewhat wobbly. He went outside and did his "thing". They gave him his medicine wrapped in some ham which he took but when they offered him dog food he turned away. So they fed him Vienna sausages! He ate those but later on vomited, probably due to the sausages! He's not used to that type of food! Anyhow, they're going to continue giving him fluids and monitor him overnight. The neurologist still see that he has some neurological deficits but he is brighter and more alert than yesterday so we're hopeful he'll continue to improve.

If they release him tomorrow we're considering just going up to Columbia and staying Saturday night and Sunday night so we can cut out some driving and be ready to take him back in on Monday for his clinical trial evaluation. It would be nice to bring him home though if even for a little while...


*******ANOTHER UPDATE FROM LORIE***********

So Linus just went outside again and seemed to enjoy the nice weather for awhile but eventually stopped walking and just stood in one place. They gave him something called Cerenia to help control the nausea. They plan on offering him food again at 5pm. Then they will monitor him this evening and run more blood tests in the morning. I emailed Debbie Tate, the clinical trial coordinator, to let her know that soft foods are what we had Linus on this last month. So now he probably prefers them. The ataxia is still present. Lorie said he walks like he's drunk which fits in nicely with our crowd (LOL). Seriously, we hope that the ataxia will wane as he gets better and is certainly something we can cope with.

Update on Linus's return to ICU

MU called and Linus's fever is down to 104.1 but he had an allergic reaction to the plasma tranfusion. So it was stopped while they treated him with benadryl. He still has no appetite but they're hoping after the itching and facial swelling subside he will feel like eating.

In an earlier call we were told that he is anemic and low on protein. So tranfusions would be needed. A call to NIH was made and the study manager indicated that these low numbers did happen in other animals on the trial and that they had recovered.

The thing to watch for is something called capillary leak.They will recheck his bloodwork in the morning and once his temp has come down to normal they will reevaluate his neurologic response namely the weakness in his legs (ataxia). They plan to do a spinal tap to rule out some things.

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Back at the University :( - Day 4

Linus had to be taken back to MU since the fluids were not helping the fever enough and he started showing signs of ataxia. First in rear limbs then in his front limbs. I had to lift him out of the car at MU but couldn't get him to walk so I carried him into the clinic.

Bad night...

Well Linus spiked a fever of 106.3 so we had to take him for an IV at Sullivan Vet Hospital! I called the emergency service and they paged Dr. Kat Stuart. She met us at the clinic at 1am and was ready with the IV. We first tried it in his already shaved leg up on the table but it got pulled out. So she suggested he may be more comfortable on the floor so we moved down there and I held him on my lap while she shaved his other leg and started the IV. He was very quiet and just laid there.

She pushed the 1st 100 ml in within the hour then dialed it down for the rest of the night. Since we had no way to confine him we opted to leave him at the clinic for the night and check on him in the morning. Dr. Stuart was going to call MU first thing to give them the info on his status.

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Linus is home! Day 3

Linus is home and recovering from his treatment and testing. He slept most of the way home and has been pretty lethargic. I gave him his antibiotics (clindamycin) and pain meds (tramadol) but he hasn't had any appetite this evening although he has been drinking water. We're going to monitor him and hope he perks up in the morning.

This video shows where he had his neck shaved for the jugular cath and also where his front leg was shaved. I took him on a short walk down the block hoping he would perk up a bit and maybe eat some dinner. As you can see he's fairly alert.

Evening update #2

MrLacubrious took this evening's phone call from MU since I was at an appointment. He found out that Linus was treated with NHS-IL12...but we don't know if he is having any response to it yet. They said he was eating fine and doing well. We're supposed to pick him up any time after 10am tomorrow.

Morning Update - Day 2

Jen from MU called this morning to give us our update. She said that Linus was bright and energetic this morning and excited to go outside to do "his business". He's handling the treatment just fine and is not even bothered by the catheter and in fact was up and barking in his cage! I told her that can't be good for ICU but she said that they like to see that energy. Jen wasn't sure which drug he ended up with or when he will have the catheter removed but said she would find out and call us this evening with that information.

Speaking of energy, here's a pic from the time that Linus destroyed "bobo", his stuffed dog toy!

Evening update...

Well we did not get our phone call about Linus so we decided to call the emergency line and see if we could get in touch with someone who would give us an update. We were patched through to the vet tech in charge of the clinical trial. She told us that Linus was just chilling out in the ICU. He had been sedated, cathed, and received his treatment. He didn't seem to mind the blood draws from the catheter but he was not becoming a fan of the rectal temp check! Other than that she said he was being a good patient and we should be proud of him. So good news so far. We should get another update tomorrow then pick him up on Wednesday!

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Morning update...IL-12 Injection Day 1

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Originally uploaded by dehmystic

Jen Wolf called from MU Vet School to let us know that Linus had a good night and was alert and in good spirits this morning. He was walked and went potty normally.

The plan for the day was to sedate him for the jugular catheterization (ewww) and inject the clinical trial meds. She promised to call around 5pm to give us an update on his status. She also confirmed that he will be in ICU until we pick him up on Wednesday.

WE miss him!

Yesterday I took him for a walk with Baby so he would be calmer for the ride. We headed out around 3pm to take him to Columbia and we stopped to buy him a plain hamburger (minus bread), which he LOVED! He even licked the wrapper! Then he settled in for the ride. We got delayed by a motorcycle accident on Hwy 47 just past Marthasville but I made up the time on the Interstate. (I will not tell you how fast I drove!) We ended up 15 minutes late but it was fine. We signed the Hospitalization Agreement and resuscitation authorization. Then they took him away. DH and I got the heck outta there before we put too much thought (tears) into it, headed to Flat Branch for a couple of beers and a snack then out of town and back home to Baby.

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Originally uploaded by dehmystic

Committment...

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.

Change of plans...

On the advice of our vet, I called/emailed the Veterinary School in Columbia, Mo. I thought that the least I could do was find out about the clinical trial and see whether it would be an option.

What I found out is if Linus doesn't have a tumor that they can monitor then he probably won't qualify. I did find out that we would have to pay for the initial workup ($300 - $400) but if the dog is accepted in the study then the associated costs are covered which would be wonderful.

We've decided to take Linus up there for a review of his situation and just see what they say. I cancelled our local oncologist appointment for Monday and instead I'll take Linus up to Columbia on Tuesday.

I did call the local oncologist office just to get an idea of the expense...The vaccination is $525 and there would be 4 of them, one every two weeks. This brings the cost to $2,100 not including any workup, xrays, etc....so that is something we will need to think about.

It might just be that we will have to wait for the melanoma to become visible as another tumor before the University will accept him. Though delaying treatment doesn't seem a wise choice either.

On another note I received the copy of Linus's lab work and pathology report. His bloodwork suggests that he may have an iron deficiency. NO ONE even mentioned this at the vets office so I'll bring it up at his holistic vet appointment on Saturday and see what we need to do there. I guess I need to feed him some raw meatballs or something!

AKC Gazette Article

Here's a link to a pdf article that appeared in AKC Gazette last year which explains the science behind the melanoma vaccine.

I printed a copy and took it to Dr. Franklin today when I dropped off Linus for his appointment. Since he did not mention the vaccine when he told me about Linus's melanoma, I thought he might be interested to know that it is available, although limited only to vet oncologists at this time.