Story told by Bret and Traci Preble
Libbie is our 12 year old beagle. She has given us an incredible amount of love, devotion, companionship and joy. Our lives have been greatly enriched with her sweet disposition, her bright eyes, her good nature and she fills a huge place in our hearts.
On December 27, 2008 she became mildy lethargic and wasn't as interested in food. We were at our vacation home in the snow and assumed it was the environment. On 1/4/09 she got into the bathroom trash and ate 2 tampons and a bunch of toilet paper. We came home and watched for signs of obstruction but there was none. She started to decline around 1/10/09 and fever started 1/15/09. We took her to the vet on 1/16/09 where xrays showed very enlarged liver and spleen. On 11/14/08 she was diagnosed and treated for crystaluria. She had abdominal xrays then and her organs were normal size so they had something to compare with. Blood tests from 1/16/09 showed she was anemic and blood was not clotting. She began taking vitamin K and iron. Ultrasound was performed on 1/22/09 and showed no obstruction or complications from an obstruction but multiple masses in liver, spleen and lymph nodes. Radiologist suspected intra-abdominal metastatic neoplasia. Due to the size and number of masses fine needle aspirations were done at that time (could not do an ultrasound guided biopsy due to her clotting factor). Probable histiocytosis was the result of the FNA. The next round of bloodwork showed her blood was clotting well enough to have an ultrasound guided biopsy so one was done by an oncologist on 1/28/09. A bone marrow sample was also collected. Results came back; probable histiocytosis. On 2/2/09 we requested a special immunohist. staining to confirm histiocytosis. Diagnosis came back on 2/13/09: splenic sinus histiocytosis compatible with histiocytic sarcoma. We will not be pursueing any further diagnostics at this time.
She took her first dose of Lomustine on 2/3/09. Other meds she's started include prednisone, antibiotics and herbs. She gets acupuncture as well. On 2/10/09--one week after the Lomustine was given--she had more bloodwork. That evening she developed a very high fever and required 2 days of IV antibiotics. The bloodwork from 2/10/09 showed her platelet count was extremely low...lower than anticipated and she was still anemic which couldn't be blamed on the chemo. So next round of chemo will be adjusted to hopefully prevent this type of reaction from happening again. She has not had a fever since 2/12/09 and seems to be bouncing back.
We got Libbie from a private party who owned her mom and dad. They were not an established or backyard breeder but bred their dogs as a hobby with great care. The parents were purchased from different parts of the country from different blood lines to try and avoid inbreeding issues. Both parents did have AKC papers and we have AKC papers for Libbie. A year later we got Max from the same family and dog parents. He has a couple of health issues including epilepsy and episcleritis but at this time is showing no signs or symptoms of histiocytic disease.
Libbie spent February 19, 2009 at the hospital because she was extremely anemic. We tried cross matching her with Max and 2 of the doctors dogs but Libbie's blood was agglutinating with her own blood so the dr. consulted with an internist who said because of what was happening with her blood she should not receive blood from a donor dog. So the next day she was infused with oxy-globin-a synthetic blood. There was of course risks...but we were hopeful and everything went perfectly. An xray showed her spleen decreased considerably in size and her liver appeared unchanged. Her blood work came back showing her platelets were normal and her white blood count was still very low but increased from last week so things seem to be turning around for her, at least for now.
On March 1st Libbie's bloodwork and ultrasound results were very promising. Her body was finally making red bood cells so she could start supplementing with iron pills. Her white blood count went from .4 (2/10) to .9 (2/19) and was now 20.2!!! Her platelets were normal and hemacrit was slowly creeping up and was now 16.9%. An ultrasound showed only 1-2 masses in spleen, 1 large lymph node in belly and 4-5 masses in her liver so the chemo appeared to be doing it's job.
I gave her the 2nd round of ccnu on Monday March 2nd, 2009 and everything seemed fine. The dose had been lowered from 46mg to 37mg and we took preventative steps to avoid infection.
Her activity level and appetite continued and even improved. Unfortunately, her next blood test showed severe anemia again and very low platelets (no one could figure out why this was happening) so she needed another transfusion. But oxyglobin didn't contain the much needed platelets so her blood was tested to see if she could use a donor dog. The results came back showing that her blood was not agglutinating and Simon and Decker were matches. Because Decker had a higher platelet count than Simon she was chosen to be the donor dog.
On 4/3/09, the day after the transfusion Libbie had another ultrasound and it wasn't what we'd hoped for. The cancer was so severe that nothing more could be done that wouldn't destroy her already severely weakened immune sysem. Even though the blood transfusion was a success and raised her platelet, red and white blood cell counts a lot, they were still dangerously low and her body was not replacing and rebuilding anything. Any kind of chemotherapy would do more harm than good. So after talking to her doctors we decided to stop and let nature take it's course. We were told what's to come and what to watch for and hoped we have the strength to know when to let her go. We continued with supportive care and treasured each and every moment. On Saturday 4/4/09 we took a walk to the park at the end of our street...where Max and Libbie grew up playing together. We spread out a blanket and laid in the sun. Libbie seemed relaxed and comfortable, she even got up and barked at a couple of neighborhood dogs who walked over to do their business. Sunday was another beautiful, warm day so we sat on the balcony, her on my lap like we had so many times before and we listened to the birdies and sniffed the fresh air for any signs of squirrelez. A few things were happening and we knew her condition was worsening but we held her and loved her and couldn't stop crying. Do eyes ever run out of tears??? It was late Sunday night and we knew we had to make that dreadful decision so called Dr. Welsh and made the arrangements for Monday. We set up a bed in our living room and laid her between us. Knowing this was to be our last night with her, neither one of us slept. She breathed softly and felt relaxed and content. I forced myself to stopped crying in order to clear my stuffy nose so I could breathe in her smells and remember them forever. Monday morning she ate pizza and drank water. The day was long and the tears were many. She fidgeted alot like she couldn't get comfortable so we knew we were making the right decision. She watched our every move and only took her eyes off of us long enough to rest her head down when she was too tired to hold it up anymore. We don't believe she was suffering or in pain...she just seemed uncomfortable and weak. Certainly not the bouncy, happy, perky pup we'd known. We felt confident the time was right; we hadn't ended her life too early nor too late. We were fearful that something would happen and she'd need to be rushed to the emergency hospital and die in the hands of strangers, in a strange place, in horrific pain and terror. We're grateful this did not happen. At 5pm on Monday April 6, 2009 Libbie passed peacefully in our home, in our arms, surrounded with love. Her big brown eyes closed and her warm body went limp as if she'd simply fallen asleep. Dr. Welsh and Dr. Sanders helped her make that transition with compassion and care.
We were utterly unprepared for the flood of tears and grief we felt at her passing. The heartache and emptiness we feel is immeasurable and deeper than we thought possible. How is it that a little dog's passing can bring such sorrow and sadness? Maybe we are a mess of tears now because we were loved by Libbie unconditionally and this grief is the way the gift of unconditional love is painfully but properly repaid. We know there are those who will never understand the deep feelings of loss and grief we are experiencing and that incredible bond that is created when your pet suffers an illness. We cannot and will not feel embarrassed at feeling bereft because of the death of our dog. Unless someone has personally experienced the loss of a truly beloved pet they are simply unable to connect with those who are grief stricken by the loss. But we know there are others who have taken the same sad path as us and understand how inconsolable we are with losing Libbie. Our precious little girl is gone but her memories and the love we feel in our hearts will live inside us forever.
This is Libbie: http://tracis.info/libbiespage.htm