If you remember, a while ago I announced the painful news that my Indy had just been operated by the Dick White Referrals Specialist Centre in Cambridgeshire to remove a canine anal gland cancer in the left anal gland – if you missed that post, please click here. At the time, we were waiting to hear back from the surgical team to give us the outcome of the operation and the results on the biopsy. I thought it only but fair to keep you up to date with further developments on Indy’s journey through cancer.
For starters, and to set aside any concerns many of you kindly shared with us, Indy is still with us!!! And the road to where we are now has not been massively difficult, nevertheless not free of issues.
Indy came home two days before Christmas, when we had already organised to have a few family members coming over on Christmas day. My mum also stayed with us for some 5 weeks. Which meant when Indy came back home from his surgery, he did not find the usual routine to expect him – he found excitement but also lots of people wanting to fuss him and, possibly, wanting to be ‘on his face’.
On leaving Dick White Referrals on the previous Friday, we were advised to keep Indy on very short walks for no longer than 15 minutes, and to keep him away from toys and from playing tag-of-war. This was so he would not put pressure and strain on his flank and derriere’s muscles. He was also prescribed antibiotics and anti-inflammatory medicine as well as some natural supplements to keep his faeces softer. Again, all of this was with the aim for his backside not to get infected and for the muscles not to strain.
Indy was extremely well behaved on Christmas Day, and in fact we struggled to keep him still, which was rather against doctor’s orders. But the excitement of Christmas wrappings and treats and toy was too hard to resist!
Once the Christmas was over, however, reality started kicking in. Indy kept being sick and not much keen on food – we were advised for the first few weeks to change his diet to a bland one of chicken and possibly rice, which I started cooking for him. We spoke to doctors at Dick White Referrals for advice, and jointly we decided to wean him down gradually from the medicines whilst again slow but sure reintroducing him to his normal diet.
Within a few days, Indy stopped the vomiting and his appetite returned. Also, his toilet functions went back to normal. We were on the way to recovery!
Our Indy was back to normal. We were advised to expect some incontinence for the first few weeks, and Indy had none. His wound barely bled for the first couple of days and then again scabbed beautifully. Which meant we have been very luck with our Indy. Once again he proved that he is strong minded in wanting to get better, that in our mind he has become nearly invincible!
Our biggest concern, however, was whether we were going to notice any behavioural changes in Indy. This could mean that either cancer was still lingering, or that after all our Indy was ageing, and because of the surgery he was prematurely fading away.
Round about a week after his surgery, UK started seeing the cold weather advance rapidly. Indy became very unenthusiastic about walks. We reduced the walks to one a day, and naturally also reduced the length and distance of the walk. We finally adjusted walk time to late morning or early afternoon. Yet, we could not manage to get Indy to walk to the end of the road without having to carry him – and as soon as we put him to the ground, he would just head straight back home. Was this due to the colder weather or because his operation had left him lethargic?
We assumed it may be a combination of the two things, although Indy was far from lethargic indoors – which, in a way, was reassuring. We had to find a way to break that circle, to get him out of his territory, so he could regain interest in less usual grounds and could be stimulated by new smells and interests. That’s when the good old dog stroller came out of the cupboard and proved an invaluable help.
Indy has a very lay back attitude towards life. That has proved to be the case with is walks too. Because for as long as the weather has kept cold – and I mean really cold – we would keep the walks to once a day, usually soon after I was back from work or midday when at home. And I have been putting Indy in the stroller, pushed him in different directions from the house, and once at a relatively good distance, I would take him out of the stroller and he would not walk back towards home but would be quite happy to walk forward, this time interested in the relatively new surrounding.
Now that the weather is turning milder, we can safely say that Indy has fully recovered to display his usual behavioural traits. We are still making concessions to the fact that Indy is 12 and a half, and negotiating between the one and two walks a day. Indy still favours walks in the middle of the day rather than first thing in the morning as he used to. He doesn’t mind late afternoon walks. But otherwise Indy now is happy to go for walks without the aid of the stroller. We will still take the stroller with us when going for longer walks, but otherwise Indy is having a new epiphany, like a re-birth in body and mind!
But, what was the outcome of the surgery?
The lovely Georgia, soft tissue surgeon who operated on Indy at Dick White Referrals, explained that they were confident by removing the left anal gland, they had got rid of all the cancer and the surrounding tissue, although the area does not offer much in the way of spare tissue to be removed. However the biopsy had indeed confirmed her diagnosis of melanoma, which in dogs is malignant.
When we were referred to Internal Medicine consultant Rachel, she explained that again they were confident the cancer had been removed in its entirety, but melanoma does come back and we were to decide on which cancer treatment to follow the post-surgery intervention.
There were two aspects to Indy’s cancer. The first thing was that melanoma in dogs presents on their paw or in the eyelid or mouth. Although Dick White staff had encountered a few more cases like Indy’s, melanoma in the anal glands is extremely rare – for this reason it was difficult to work on statistical grounds as to which type of cancer treatment to choose from.
The other aspect in Indy’s cancer was however reassuring. Bear with me for a minute as we are about to delve into the right and proper scientific aspect of dog cancer. It was found that Indy’s mitotic index (or MI) was 5. Now, MI is the rate of cell division in canine cancers, and it is deemed that when MI is equal or below 5, the cancer is unlikely to spread or is of a benign nature, when equal and above 5 however it is not good news and the survival rate is reduced to a few more months.
With Rachel we discussed the combinations of all the above factors, i.e. the fact that the melanoma was malignant, in a rare part of his body for which there are not many statistical possible outcomes in terms of prolonging life intervention, and the fact that his MI sat on the rate of 5. She then explained that chemotherapy has a low success rate of 30% with canine melanoma, and dogs suffer. With radiotherapy again dogs will have an adverse reaction, but the success rate increases to 40-50%. And then Rachel went to introducing us to melanoma vaccine.
We had already found out about this type of vaccine when our regular vet gave us a basic diagnosis ahead of referring us to Dick White Referrals.
This vaccine was discovered some 8 years ago, and is meant to act as an antidote to the reformation of melanoma affected cells. Rachel went on to explaining that figures collated to this moment in time relate to the most commonly presented melanomas in dogs, and they show a higher success rate when the vaccine was first introduced to veterinary centres than more recently. The most current figures are not quite clear as to the success rate of the vaccine, as it has been proven in the meantime that far too many different factors influence the outcome. However the advantage of this vaccine is that it causes no adverse reaction to dogs. And this was the factor that sold this solution to us!
Indy was given his first vaccine last week, in a form of an injection given on the thigh by an air compressed syringe. He was kept under observation for 20 minutes to ensure he may not have any allergic reaction, and then we were on our way. One week later, Indy has shown no signs of unwell being symptoms.
Indy is due to have another 3 vaccines between now and the end of March – one every fortnight – and then a booster every six month for the rest of his life. Due to the unknown success rate, Rachel explained some dogs so far have had cancer come back aggressively within months, but other dogs are still on their books after receiving the treatment for the last 4 years. We are hoping to fall within this category.
The journey continues
So far we are delighted with the outcome of Indy’s ordeal. If you had asked us at the beginning of December whether our Indy would still be with us two and half months later, and live and kicking, we would have burst in tears.
Now we look at our Indy, and check his progress every day as if he were a puppy going through his development stages.
Please do not judge us for taking the path we have taken. From not wanting to put Indy through any procedure, to putting through surgery and now cancer treatment, it is a total different stance. But, given that our Indy is still with us, and is well, we don’t regret the decisions taken so far.
Our main concern is for our Indy to retain his quality of life and not to suffer. We are aware that one day the bubble will burst and we will be landed with the devastating and final news. And that day we will, unwillingly, accept that that is the end of the journey. No more treatments, just lots of love.
But until that day, provided Indy is not put through suffering and veterinary science can help him, we shall endeavour to do our very and utmost best by him.
If your dog has gone through cancer, I would love to hear from you about your experience. Please leave your comment below. Thank you.