A DAMN GOOD DOG with Neurofibrosarcoma

This is the story of Buck. You see, when I needed to do research, I could find very little about this topic: radiation therapy for neurofibrosarcoma in a paw of a 3-year old dog. I'm hoping that maybe this story can help someone else one day as I will post pictures as we continue his treatment.

But first, some background. Buck just turned 3 on June 12th, which is the birthdate Atlanta Lab Rescue gave him when they took him from Spaulding County Animal Control. He lived in doggie daycare, no foster for over a month before the fateful day when 2 broken-hearted people met him for the first time. We had just lost our 15-yr-old legendary cat Herschel to age & feline heart/kidney failure. We happened upon an adoption event and when we got on the ground to meet him, he went belly up on Travis's lap...and the rest is history. His older sister Georgia gave her stamp of approval and he joined the family. He's been what we call "lumpy bumpy" from day 1. Within his first months with us, we removed a growth from a back paw, it was benign. He gets little skin tags on his mouth and tongue. In the Spring of this year, he had a growth literally in his anus. It was also benign but something we need to remove at some point if it grows larger.

So when we noticed a pea-sized growth on the front right paw, we knew to watch it. We didn't freak out over it. Until it started to grow fairly quickly over a month. While I was out of town over a weekend, Travis took him to the vet to check it out. Our vet aspirated it, meaning she took a sample and looked at it. She didn't like what she saw and he had surgery to remove it a few days later. That mass was sent to the lab.

The results were not good. It was not benign this time, and we didn't get clean margins on what was removed, which means, the mass didn't come out intact. What we have learned about neurofibrosarcoma, a nerve sheath tumor, is that it grows like an octopus with tentacles. So there are pieces in the delicate toe/tendon area of his paw that could not easily be removed. And guess what? Each piece left behind can regrow it's own tumor and when it grows back, comes back aggressively. 

Choices are limited. If the cancer has not spread which in our case, it has not, you can 1) amputate the leg or 2) get radiation therapy. Our vet sent his case to UGA Veterinary College and to Blue Pearl, the canine oncology specialists in our area. Both recommended, at his grade 1 level, that a radiation course of treatment (19 days excluding weekends) would be a good choice and give him a 75-80% chance of remission at 5 years. 

We chose Blue Pearl due to the proximity to our home. While we love UGA, we would've had to board him there for 4 weeks during the treatment due to location and job schedules. We had a consultation with one of the Blue Pearl oncologists and he answered many of our questions. We did an x-ray and a lymph node biopsy (one was swollen) to make sure nothing had spread as we had to wait 5 weeks for his paw to heal post-surgery. We got the all clear, and approved the estimate (in Atlanta at this facility, for his paw, is in the $5K range), and booked his first appointment.

DAY ONE 8/14/18
Buck had to fast (no food after midnight) and his appt was at 9:00. His paw had to be "mapped" so the appointment was to be longer than the remaining sessions. He is sedated for each session. He came home with white markings on his paw that we are not supposed to wash off. Of course, he wants to lick them off. So far, paw looks "normal" and his demeanor is a little low-key. 

DAYS 2-4, 8/15-8/17/18
He hid under the chair in the clinic this morning before his appointment when the vet tech came out to get him. He has also been very tired and subdued when he comes home from his sessions. Otherwise, we've seen no symptoms or side effects but we know they are coming (sunburn, fur loss, paw pad sloughing). He is still enjoying his walks and will play with his toys and sister. He gets a break over the weekend.

TREATMENT DAYS 5-6, 8/20-8/21/18
No outward, physical side effects are visible yet but we think the treatments are starting to take an invisible toll. He comes out of the anesthesia quickly and the vet clinic prefers that he recover at home versus in a cage (which we agree with) but he quickly passes back out after eating his breakfast and sleeps the majority of the day. We know that sleeping is a normal dog behavior but when it's combined with a subdued demeanor, we think it's starting to wear on him.

​13 more to go.

TREATMENT DAYS 7-9, 8/22-8/24/18
Fairly "normal" days, except we asked the vets about his energy at night. Since he recovers most of the day, he was wound up at 10:00PM when the humans would like to sleep. He would whine, bark and dance around to continuously go back outside to chase things (frogs) in our backyard. They recommended Melatonin, which did help settle him down when we have tried it.

He is starting to limp and he has cried in his sleep. His paw is physically warmer than the others. It makes us sad as we know the treatment is basically cooking the inside of his paw. 

We are having to keep the cone of shame on him more often as well as he does want to lick it. 

We only have 9 more treatment days to go...with the Labor Day holiday approaching, he will double up on the last day.

TREATMENT DAYS 10-15, 8/27-8/31/18
It was challenging to get through, but the vets at Blue Pearl ended treatment early based on the amount of paw pad that was sloughing off. He doubled up on the last day to have 2 treatments - which brought him to the grand total of 16 radiation treatments.

When you hear the paw pad will slough off, I was imagining the whole cushion part would come off, but it's really the extra layer of skin on the pad part itself. His pads are black, so chunks of black skin fell off.

After care was rough, changing bandages as the paw heals. We would lightly rinse it with warm water, apply SDS cream and wrap. His fur did fall out only in the paw area as did his toe nails and crusty paw pad.

We were warned that his nails and fur would grow back clear and white. Which they did. It was weird but I'll take that over having to amputate his leg any day of the week. 

His spirits were mopey as he healed. It took about 2 months before he started to play with toys and his sister, Georgia, again.

UPDATE September 2019: We are a year past his treatment and X-rays (done quarterly) show that his lungs remain clear of any cancer spread and we've had NO NEW LUMPS!! He remains happy and healthy a year later which makes all that we went through, worth it.


​ 

Handsome Buck, the week before treatment begins.

Day 1: Markings to guide the laser are added. We can't let him lick it off. We had to break the cone of shame out on Day 4.

Day 2: Big sister Georgia showing solidarity by napping close by after a long day.

Day 4: Sweet boy buries his head in a blanket on my lap when I get home after date night.

One bright spot was the colorful bandages we would get and wrap him up with.

We started to see the radiation effects between his toes. It was raw, sticky and gooey. Keeping it clean was very important.

The initial start of paw pad sloughing.

The throes of paw sloughing. This is as bad as it got.

The start of the toe nails falling off. The pink part is the "quick" which changes to white later.

We found humor in the middle toe nail staying on the longest. It was him "flipping off" cancer!

All nails have fallen off. He is all tucked up taking a nap. (his nose is behind the back paw).

Post-Recovery: As the fur and nails grew back in, they came in differently than before. You can actually see the "line of demarcation" where the fur is white compared to his glossy black/brindle fur.