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Louie's journey with Transitional Cell Carcinoma (TCC)


First a little about Louie's life story. Louie came into our life through Precious Secrets Sheltie Rescue in Cincinnati, Ohio. Our first Sheltie Maddie came from there and we made a practice to keep an eye on the PSSR web site, after all Maddie was perfect so where else would we look for a Sheltie should we ever decide to adopt another one. We followed Louie's story from the time he was listed as a very sick boy who came to them with pancreatitis and pneumonia, he was dying. They showed a picture of his little body, shaved and with tubes and amazingly a big smile. He managed to get a little better and they decided to give him a chance and continued treatment. We followed his story and decided that when he was well enough we wanted him to join our family. Finally, when he was ready Precious Secrets arranged transport to Columbus about halfway to our house where we picked him up and brought him home. He was so very thin and missing lots of hair, and he happily bounced into our house like he always lived here. http://pssr.org/louie.html

We took him to the vet for a physical and to give them his recent medical history. The rescue said he was guessed to be eight, his medical records from Ohio said he was nine and our vet laughed and said ten at least. Based on his activity level we have always suspected he was much younger! He had many fears -bugs, flashes, cameras, and people climbing on chairs, sweepers, oven timer, smoke alarms and multiple other things. When we walked, all the dogs in the neighborhood seemed to know he was coming and barked at him from both inside and out. Louie hated that and barked, pulled and spinned. We finally decided that all the stress over walking couldn't be good for him and discontinued the daily walks. Now if he walks, he walks early in the mornings when most everyone is in bed. He gets his exercise in the backyard with his ball and Frisbee. He is a much happier and calmer dog once we quit walking him. Over time we learned how to deal with his fears and now we have a much quieter household. He came to us with this cough, he makes a sound similar to a cat coughing up a hairball, he never threw-up but we thought there must be something not right. We talked to the vet and he was given antibiotics but it never really fixed it. Finally, I videoed him doing it and showed it to the vet, Louie had an x-ray which showed a collapsing trachea he was given medicine for it. He was also diagnosed with high blood pressure at another time and takes medicine for that too.

This year in February when he went for his physical he was found to have a urinary tract infection and was ordered an antibiotic for two weeks. His follow up urinalysis showed he still had it, so he was sent home with another wide spectrum antibiotic. Again after another urinalysis it still showed that he was not better. Another antibiotic was ordered this time for a month and we were told if this did not cure it we should do further tests. About this time he started to take a long time to pee, he would go a little walk a few steps and go some more. He would do this over and over again and he was also making this little sound, similar to the sounds raccoons make while he was trying to go. He also seemed to be having trouble having a bowel movement, he kept trying and trying with no results and when he finally was able to go it was soft. We were pretty sure he wasn't better. When the next urinalysis showed he still had a UTI and a ultra sound was scheduled.

On 5/24/10 we went for the ultra sound. I expected bladder stones, Maddie, had a lot of UTI's and x-rays showed she had bladder stones she ultimately had to have surgery to remove them. I thought probably we were starting down the same path with Louie. After the ultra sound we stopped at the vets to get the results of the test. The vet graciously saw us even though we did not have an appointment. I was shocked to hear the results - Transitionsal Cell Carcinoma (TCC) - cancer, the vet drew pictures of where it was and told me lots of things most of which I didn't remember and had to call back for clarification several days later. The vet explained the options available for his type of cancer. 1. Operate and remove the tumor but that wasn't an option for Louie, his tumor is located in the neck of the bladder and in that location it is not operable. 2. Chemotherapy - sometimes it buys a little time but not much. 3. Treat with NASID's - this has been shown to shrink the tumor or slow down the growth of the tumor in many cases. I chose to treat with NASID and was sent home with Deramaxx to be given once a day. What was most devastating to me was that it was not curable that we would have at most six month to a year left to love him. The Deramaxx was like a miracle, he seemed to be able to pee much easier, still peeing walking and peeing some more.

I decided to search the internet to see if there was other information out there, something that would fix him. What I found was basic all the same information that the vet had told me.

Some helpful sites that explain the condition and options are

http://www.marvistavet.com/html/body_transitional_cell_carcinoma.html
http://www.medvet-cves.com/pdf/Transitional_Cell_Carcinoma.pdf
http://www.petplace.com/dogs/urinary-bladder-cancer-in-dogs/page1.aspx
http://www.vet.purdue.edu/pcop/CanineUrinaryBladderCancer.pdf

At the American Shetland Sheepdog Association site I read about a study that was being done to discover the genetic causes of TCC. I E-mailed and inquired to see if they were interested in Louie. Since he is a rescue I was unable to provide all the information they wanted. In addition he was not biopsied but was diagnosed by ultrasound. They were interested in him and also Meggie our 2 year old Sheltie, who is healthy, they sent two kits and we made arrangements with our vet, who graciously at no cost drew the blood and packaged it to be sent back.

Another site that has been most helpful for me is

http://www.cancercompass.com/message-board/message/all,1543,0.htm

It is a thread from Cancer Compass that has been going on since 2005. Everyone responding to the thread has a dog with TCC. I started at the beginning and read them all, most heart breaking is the fact that none, not even one dog has survived long term (a couple years) if they survive even one year they are extremely lucky. Different people choose different treatments but the end is always the same no matter what treatment, or supplements are being given. It is comforting to talk with others who are going through the same thing and sad at the same time. You are happy when a dog is eating or peeing better or they got a good report, but then there are those who die and your heart breaks for their family and you know that sometime sooner than you want it will be you.

Louie remains on the Deramaxx rather than Piroxicam that most of the dogs are taking so he doesn't have the stomach problems that many of others have. At the beginning of this "adventure" it was hard to believe that he really was so sick, he didn't act sick (if you ignored the fact that he couldn't pee or poop easily). Now he is in pain a lot, he takes Tramadol three times a day and we are increasing the amount we give him. He is still eating good and takes his many medicines pretty good most of the time although it is getting more challenging to get them down him now. The vet says this week that his tumor is the size of a meatball and his prostrate is enlarged, between the two it doesn't he doesn't have much room left to pee. He doesn't know he is sick and we aren't about to tell him, well maybe he suspects, he is getting even more loving, sitting as close as he can get resting his head on my leg or sitting in my lap. We are starting to see him have bad and scary for us days. He has been on antibiotics several times which have helped perk him up to the new normal. I know it can't go on forever but we will love him each and every day that we have left. It really puts things into perspective, it doesn't matter that I can no longer open the door and just let him out but have to take his "Panties" off first, it doesn't matter if he pees or poops on the deck because he won't go in the yard anymore, I'm just happy he is here and I can clean it off. It doesn't matter that his medicine, vet appointments and pee pads are costing a small fortune, it is only money and Louie is worth every penny of it. It doesn't matter that I run home every day after work scared that I won't hear his bark because when I open that door and see his loving eyes the love for him that floods my heart takes away the fear. On Thanksgiving, he will pass the six months average survival time and we will have much to be thankful for.

On Saturday, November 20, 2010, Louie left this world wrapped in love in the arms of his Mama.

The following is the note I sent to his rescue following his death.

There have been several things in my life that I have seen or experienced that I have known was a once in a lifetime thing. Once I walked into a field and thousands of Monarch butterflies rose from the plants and flew around me. Once at Presque Isle at the end of winter there are ice dunes and it was a sunny and sort of warm day, I ran my hand along the side of one of the dunes and thousands of little beads of ice fell loose and sparkled like diamonds as they fell to the ground. Once Betsy and I followed a mama black bear and her three cubs around the woods for days while on vacation. Every day we went back to the same place and she was there, we watched her nursing the cubs and could hear their little humming sounds as they sucked. Another time we watched a turtle lay her little pink eggs and cover them and go back to the water. And lastly, Louie's love.

Louie has always been very intense; he either hated something or loves it with a passion. Louie has loved me/us with a passion. The other dogs love us but they have other interests too. Louie LOVED us, we were his LIFE. Oh, he liked his balls and Frisbees and playing with them, he liked lying on the deck watching for the neighbor to come out and throw him treats. But he loved being with us best, he was never far away from us, if we got up to do something, well obviously he was coming too. Even in the middle of the night, when we got up to go to the bathroom he came along. His little eyes never strayed far from us.

These past six months have been full of trying to make memories that will last a lifetime; we have taken hundreds of pictures both in our heart and camera. I have told him thousands of times that he was Mamas' best boy, that Mama loved her baby boy and he told me thousands of times with his eyes that he loved me too; he gave me more kisses than anyone deserves.

The past month he stopped following us to the bathroom but that didn't mean that he didn't pick his head up and watch for us to come back. (We all sleep in the living room, me on the couch, Betsy on the floor and Louie usually next to the couch). He was having a harder time going to the bathroom, taking longer and not getting much out, he made crying type sounds while he was going. Many times I had to carry him out because when he had to go he hurt so bad he couldn't walk. He wore his "panties" fulltime the last month or so. He also had trouble getting comfortable after peeing, he would try to sit down but was in pain so he would stand and then try to lie down again. We increased the pain medicine and as long as we could control the pain he could eat and did pretty well with that until the last couple of days. If he was in too much pain he wouldn't take the medicine or anything else, it became a balancing act trying to get the right amount of medicine in him at the right time. I said to Betsy, if we could just keep the medicines timing right he wouldn't be in too much pain. And she said, "for what, to look pretty?" I went to work and thought about what his life had become, the hours in the middle of the night trying to convince him to take the Tramadol so he would feel better, the standing in the rain trying to pee/poop, laying watching life go on around him but not being able to join in. I guess I had become so caught up in trying to help him live that I didn't see what was really happening to him. He would have happily continued on because he loved us but I knew that I had to love him more and let him go.

On Friday, I took a half day off and went home to spend it with him, we sat on the couch together and I told him how special he was to me… I bought him Beneful turkey dinner in those little tubs, it looks like people food and he happily ate half of it. I was careful to give him his pain medicine six rather than eight hours apart so he wouldn't hurt too much. We decided that we would be going to the vet in the morning to put an end to his suffering unless he was better when we got up.

At bedtime he started out on the couch with me but later got on the floor. He seemed to be resting quietly, although awake and I didn't give him his pain medicine. I was hoping it wouldn't be a mistake. (The past week every time he ate anything it caused him to want to go to the bathroom and then that caused pain). I got down on the floor next to him so we could be close and he drug his little body up by my face and I knew then that he wasn't able to walk. It was hours before light but he didn't seem to be in pain, so we stayed there the rest of the night and I put him back on the couch in the morning. He didn't seem concerned that he couldn't walk nor did he seem to be in pain. I offered him the rest of the Beneful and gave him a pain pill anyway, he took both happily. Then he had to go to the bathroom and I carried him out and held him up as his back legs wouldn't hold him so he could get a couple dribbles out. I carried him back to the couch and called the vet. I told him that I loved him so much that we were going to make the pain go away and that he would be going to see Maddie. I held him in my arms and told him that Mama loved her baby boy as he took his final breath.

I know in my heart that there will never be another that will love me as much as Louie has, it was a once in a lifetime love…...




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