Story told by Pat H.

How could I ever know when that little unplanned ball of fluff arrived on the plane just a few short years ago, how deeply he would affect my life with his gentle heart and enormous capacity for love, unlike any other dog I’ve shared my life with. There have been others, but none quite like Tenor. With eyes that were truly the window to his soul, his eyes reflected every emotion he was feeling. He had such a cute sense of humor and so many loveable actions that were truly unique. Very social and always a gentleman, you could bring Tenor anywhere and know that he’d behave. Tenor most loved and lived for his “rides to anywhere”. He even thought going to the vet was a social event, sitting in the waiting room so proud of himself, because he was sure everyone else was there to see him, until he got sick and was there far too often. How unfortunate that none of the people he saw throughout his illness ever got to see the real Tenor or appreciate what a unique and special boy he was.

April 13, 2009 Tenor’s story with Histiocytic Sarcoma began on this Monday. To my knowledge he was in perfect health on that day and had been for most of his life. He had his heartworm check and rabies vaccination that day. Much to my surprise, this was also the first time I’d ever seen a Vet give a rabies vaccination sub-q in the neck area. For the next few days he was quieter than normal and by that weekend the hair had fallen out where he had been given the shot and the skin was scaly surrounding the hair loss. By Sunday he was running a very high temperature. He wouldn’t eat. For the first time in his life Tenor was turning down food. He had obviously had a vaccine reaction for the first time in his life. We also found out the same week that my mother had cancer, so unfortunately for Tenor, I wasn’t able to get him in immediately as I would have liked.

April 23rd 2009 he was seen by the vet and I expressed my concerns about the reaction and possible autoimmune problems resulting from that. He still had a temp, his white count was elevated and he was slightly anemic. He was given IV fluids and antibiotics but not the prednisone I thought he needed and asked for. His temp continued to run between 104 and 105. Whenever his temp was high he didn’t want to eat.

April 30th 2009 We went back to the vet with his symptoms not improving. His white count had elevated further, red count had dropped further, he ran some tests to rule out other things…things I knew he couldn’t have, changed the antibiotic and finally put him on the prednisone I’d been asking for, a typical lower dose, to be weaned off within 3 weeks. His chemistry panel was normal for his age. He had checked with the vaccine company and they thought it might be vasculitis from the vaccine reaction. He wanted to refer me to the U of M College of Veterinary Medicine, but due to previous bad experiences there and my mother’s situation, I initially balked at taking him there. With the prednisone Tenor felt much better and his temp finally went back to normal, but within a few days the temperature was back and the skin reaction to the shot had proceeded into his scalp and ears…the scalp had a burnt appearance and his head looked like it had been snowing from all the flaking.

May 7th 2009 Tenor’s temp went high again and he was having some trouble getting up. My vet said he needed more help than he could offer. He really didn’t want to be involved anymore. We finally went to the U of M small animal hospital and the intern we saw absolutely didn’t want to hear about anything autoimmune from the minute she walked in…whatever he had, had to be anything but that. They re-ran all his tests and found a marked increase in his white count, anemia with a marked regenerative response in his red count and signs that his body was producing antibodies against his red blood cells. Other tests were pretty much normal. She checked his joints and Tenor yiped when she grabbed a front leg. His joints appeared to be slightly warm and painful to her. They did xrays of his front carpus and chest xrays and found a tumor in his lungs…at first they thought two. I was not expecting that one at all…Tenor had not been having any trouble breathing nor doing any coughing…no symptoms of anything whatsoever till he was vaccinated. Upon finding the tumor, any symptom my dog ever had or ever would have was, in their opinion, paraneoplastic syndrome. She said it was not caused by the vaccine nor autoimmune…“it was all just a horrible coincidence”. Somehow I don’t believe in coincidences like that…like I would ever believe the tumor made the hair fall out and caused the skin reaction in the exact spot where he’d been vaccinated. I also requested a joint tap to check for autoimmune. They sampled his joints and found a high increase in inflammatory cells as well as red blood cells present. He then had an ultrasound to check for any other masses with a fine needle aspirate of the tumor taken. They found no other tumors, with the initial sample coming back as either Histiocytic Sarcoma or an Anaplastic Carcinoma. I had pretty much resigned myself to not doing any surgery. I’d had other bad experiences there in the past and didn’t really trust them to be honest with their statistics. I did, however, request to see their alternative medicine Vet.

May 12th 2009 We saw the alternative vet. She said there was nothing she could do for us…she said that if I wanted to have him around, I needed to go the traditional route.

May 14th 2009 I went ahead and had the CT scan done. It was determined that it was only one tumor, not two. And no other tumors were found, so this was a primary lung tumor. I was told that over 50% of dogs with a primary tumor that has not metastasized and do not have respiratory signs (he had none) will live on average a year after surgery and when located on the periphery, as Tenor’s was, have even better survival times averaging 2 years. The report also said “the most prognostically important site of metastasis are the lymph nodes located next to Tenor’s lungs, which would be prophalactically removed if surgery would be performed”. Once again, all of his symptoms, including the temperature, were attributed to this tumor. With having been told I had a very good chance of having him for at least 1-2 years, how could I say no to the surgery, even though this had already become a financial hardship for us. Hope becomes priceless. I didn’t yet know that these statistics meant nothing for Tenor’s tumor type.

May 19th 2009 I met with the surgeon, who I liked and had confidence in. Tenor remained for surgery the next day.

May 20th 2009 Tenor had the left lung lobe removed that contained the tumor. The tumor and lung tissue were sent in for biopsy. They mentioned his temp had been normal while there. My thought was, he had been under anesthesia, on fluids, antibiotics, pain meds, etc and still had a couple of prednisone left. No one was ever going to convince me that all of this was just from the tumor.

May 22nd 2009 Tenor came home from the U of M hospital with antibiotics, pain meds and just two prednisone left to take. He recovered remarkably well …I was amazed. Most of his left side had been shaved, so there would be no pictures for awhile. I was happy with the surgeon and how well Tenor was recovering considering the major surgery he’d been through.

About a week later the surgeon called to say the biopsy had come back as a Histiocytic Sarcoma but a marker test would definitively rule that in or out. I paid to have the marker test done wanting it to be anything but that. I had by now spent many many hours researching and finding anything I could to read about the prognosis and treatment for the possibilities listed on the previous tumor aspirate…none of it good…and everything I read said they should always take a lymph node with this type of surgery.
I then asked if he had also removed a lymph node…he had not. Not taking a lymph node really bothered me…that was probably the only way of knowing if this had already spread. He also recommended having a bone marrow biopsy done but he said there was no point in doing one if I wasn’t going to proceed with chemo. He wanted to refer me to oncology…I asked him “why”. I had read enough to know that this type was my worst nightmare and there wasn’t a treatment that really worked or was curative if this had already spread…you might buy some time at best. He finally admitted the prognosis was not good. Had I been able to know everything up front, I never would have put him through this. All of the clinical trials I had researched were in other states…nothing here. Those were out of our reach. I decided to go see the oncologist, asking myself why I was doing this, just hoping he had something new to offer. I made the appointment with the assurance that the marker test should be back by then.

June 4th 2009 We saw the oncologist. They did not have the marker test back yet, but no one called to reschedule the appointment. The appointment went downhill quickly…I didn’t like getting the feeling my dog was nothing more than another lab animal and I didn’t particularly like this man or his ego. I had done a lot of reading including veterinary research papers, other veterinary university sites, the National Institute of Health site, clinical trials and yes…pet sites…anything I could find. He did not have the latest to offer and he actually laughed at some of the information I had found on side effects…information that came from other veterinary researchers and the National Institute of Health. When I asked about clinical trials he abruptly said they’d be happy to refer me…not that they’d check into it or perhaps make a call. He wasn’t interested at all in someone else’s research…it was him…all or nothing. And he also laughed at some of the clinical trials I mentioned that had had some small successes. Some success is better than none in my book. It’s no wonder there’s so little success with cancer treatment when making a name for yourself is more important than collaborating with others to find a cure. When my dog’s life was at stake, I didn’t appreciate being laughed at and the connotation that I didn’t have a clue. They assume everyone is just a pet owner getting their information from other pet owners. The chemo would be several thousand more and there was no way I could afford this amount on top of what this had already cost, and there was no way I’d ever feel comfortable leaving my dog with this man. As a friend said to me…by the time you get done paying them for all their testing, there’s no money left to actually help them. No matter how much Tenor meant to me, we just couldn’t afford this. The “brass ring” for my hope and his life was out of our reach. Whatever it was, was high grade, no margins given. He again stated that the first sign of reoccurrence would probably be a temperature and that it would most likely reoccur in the lungs. Because it was a cancer of the immune system itself, it could be anywhere and everywhere. We were now on our own…with no alternatives, no follow up and no one that cared. Once they realize there isn’t a blank check involved, the interest stops quickly. So we walked out the door with his statement that “you know what the statistics say” ringing in my ears. And we left with no way of knowing for sure what he actually had, or what the future would bring.

June 16th 2009 Tenor had been running a temp again the past few days and quit eating. He was acting like his mouth hurt. I found a broken molar. I did not want to return to the vet we had been previously going to, so I found a new vet and made an appointment for a dental. We met the new vet and I really liked him. Not all that long out of school, he was current and what a novelty…he was willing to listen and he actually seemed to care if Tenor felt good or not. Tenor had a dental and the molar wasn’t the problem…he found another tooth that was abscessed. As it turned out, the abscessed tooth was what had been causing the high temperatures all along…so much for paraneoplastic syndrome. Once the tooth was removed and the infection cleared up, Tenor never ran a high temp again. He’d had this all along and all of the antibiotics had been keeping it just under the radar. His head was still flaking…he has not been on prednisone since a couple of days after coming home from his surgery. I still had not heard what the marker test results were.

June 18th 2009 I finally received the marker test results in the mail…it was confirmed to be a histiocytic sarcoma.

July 16, 2009 Tenor’s flaking had been getting worse…the skin condition from the vaccination site had spread along his back and to his rear. He had also been limping. The “U” had also said rear lameness would also be a symptom of this. Within a 3-4 day period Tenor’s right eye had ulcerated, the pads on a rear foot ulcerated to the bone, it was starting on his nose and he was choking when trying to eat. It was obvious his immune system was attacking. His appetite had not been good. The vet is worried that this might be the cancer again. He did a slide of the foot and found nothing to indicate that and re-xrayed his lungs…thankfully those were still clear. He not only put him on the prednisone I’d told everyone else he needed…who wouldn’t give it to him, but also a higher dose and the progression of symptoms stopped. For the first time since this all started Tenor felt really, really good. His foot was going to take a long time to heal, but once padded and bandaged, the limping totally stopped…the pad is what had been hurting, not his rear joints. His throat healed and Tenor felt like a million bucks…he had his swagger back, was happy and eating again ravenously. I finally had my dog back…his endearing personality that I thought I would never see again, was all there for me to enjoy once more.

August, 2009 Tenor did very well until it was time to try and reduce the prednisone dose…he crashed badly the very next morning. I gave it a few days to see if he would adjust and finally called the vet to tell him this just wasn’t working. He said to put him back up to the higher dose and Tenor was back to feeling good. However, at the end of that week of trying to go down, a tiny red tinge appeared at the inside corner of the iris in the eye that had previously ulcerated. I called the opthamologist’s office that I use, feeling this was something for a specialist…I’d never seen anything like this before, but with Tenor’s continued bad luck, he was gone that entire week. I brought him to our new vet then, who thought he could see something in there…perhaps a tiny fibrous clot, possibly a tumor, he didn’t know what it was. Not knowing what it was, he said he wasn’t going to give him anything for it that day. Not feeling comfortable with that and this unknown in his eye not going away, I called the opthamologist’s office back and made an appointment .

September 4th 2009 Our appointment with the Opthamologist. Shortly after making the appointment the eye had re-ulcerated and the red area on his iris was starting to get larger…it was no longer clear and had gotten opaque. By the time we had our appointment, the opthamologist could barely see into the eye, but could see a mass…only because of the ulcer he said it could possibly be from a perforating injury with a large fibrous clot and lots of inflammation or more likely a metastases and a tumor…Tenor can no longer see out of this eye. I know at this point that this is probably a tumor, but I’m still hopeful because he didn’t mention removing it. We went home with eye medications and an appointment for a recheck.

September 14th 2009 Eye recheck…the opthamologist can’t see inside the eye at all now, the ulcer has healed so he was put on prednisolone drops to see if it would resolve any inflammation with a recheck in two weeks. I was surprised he didn’t mention removing it yet but am still hopeful because the ulcer has healed.
Thursday September 24th 2009 We didn’t make the two weeks. I got home from work to find Tenor squinting with his bad eye. I called the opthamologist to see what he thought and after a few questions, he thought it would be ok till his appointment on Monday. As the evening went on, Tenor looked like the eye was causing him great pain and he is now breathing harder, I thought from the pain. Because he hurts, he also will not eat. I gave him one of his pain pills left from his surgery. Up to this point Tenor has always been very stoic…he’s never let on that anything hurt, so I know the pain must be bad.

Friday September 25th 2009 The eye had swollen overnight so I drove him to the opthamologist without an appointment. He now says there is no hope for saving his eye, but because of his breathing and concerns that this is an ocular tumor, he wants my vet to do chest x-rays before doing surgery to remove it. We came home to our vet to do the x-rays. Tenor’s foot has almost healed, and but for the eye, he’d been feeling and doing well. I was totally blindsided by the x-ray results…the cancer was not only back in a big way, he also had fluid on his lungs. Tenor had not been coughing at all and hadn’t appeared to be breathing hard until the eye swelled…his last recheck had been clean…it was now just 2 months after his recheck, just 4 months after his surgery. His hair hadn’t even grown back yet from the surgery. I felt so cheated…my sweet sweet boy would not be coming home again. I had no idea when we got up that morning that it would be our last day together, so I never got the chance to spoil and love him like I would have liked to before having to say goodbye…in shock because I’d had no idea I would lose him that day. Had his eye not been causing him pain, I would have brought him home for the weekend and loved him like never before, but I never ever wanted him to hurt and he did. I had to make the awful decision to let him go and have peace. I held him in my arms for the last time as he left my world. I was left with all the tears and an enormous emptiness that only he could fill. It will take a long, long time to not only get over losing Tenor, but the way in which I lost him.

Now I was left with the guilt, pain, anger and all the “what ifs”. I firmly believe had I not vaccinated him , this never would have happened. He had no symptoms of anything till that fateful day. With too many sarcomas in cats caused by vaccinations to hide anymore, they’ve had to change to non-adjuvanted vaccines in cats. An adjuvant is added to a vaccine to stimulate the immune system to react to the vaccine and that adjuvant builds up in their system. This was a cancer of the immune system cells. They’ve not done that for dogs and because the highest profit comes from vaccines, most of the vets have done nothing to change the laws regarding how often they get vaccinated. I never wanted to ask “what if”…what if I’d not had him vaccinated that day, what if ‘d been able to afford the chemo, what if I’d known I was going to lose him so soon. Having graduated from an accredited Vet Tech program and having worked in the field previously, my greatest frustration came from dealing with some of the veterinary professionals…the experts… who could not see beyond their egos long enough to listen, consider all the possibilities or even care about how he was doing or feeling. I’ve waited a year since this began to write this. Our original vet has to this day never inquired about him, even though he was receiving his records through out much of this, nor has the University that did his surgery. Where are those statistics drawn from when they don’t even follow up on their own patients? Had he been given the prednisone he so desperately needed earlier and remained on it, some of the other problems may never have happened. His quality of time would have been so much better and I may have had him a bit longer. Our new vet was good to him and I’m very thankful to him for giving this little dog some quality time, even if was very short.

My heart was so broken and Tenor never deserved any of this. Why did such a sweet dog that never hurt anyone have to get this awful disease. Through much of this there was often depression. Sometimes so overwhelming it was hard to function but I still had my Tenor to love and take care of. He was the best little boy and now I can only hold him in my heart and memories. Thanks so much to Mo for her support and for keeping the memory of these dogs alive for others, who like myself, had never heard of this horrible cancer till it took an irreplaceable part of our lives.

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