YEAH!!! Raven’s white blood cell count back up to 2.5 today…which is excellent since they only need it to be 2 for treatment and last week it was 1.4
She is still in partial remission and the oncologist reckons she’s getting there. The nurse who discharged her today said that often the first three treatments will place them into partial remission and that the fourth treatment (with the strongest drug Doxorubicin) will just kick them into full remission. The Oncologist was happy with how good she was looking (this week just gone was much better than the week before that) and went with the same dose today as she got the first time. It was the Vincristine again, and as she’d had a mild reaction the first time he’d decided not to raise the dosage.
I can barely find the lymph nodes behind her stifles now which is a very positive sign. She was very happy to see me once again when I picked her up, the Nurse said she was a model patient, and very good to treat and a non-barker which every vet industry worker would appreciate I guess! So definitely good news! Monday’s have a certain sense of trepidation about them now and the news at 3.30pm is something I think about most of the day. I just hope everything goes as smoothly as it has so far.
YEAH!!! Raven’s white blood cell count back up to 2.5 today…which is excellent since they only need it to be 2 for treatment and last week it was 1.4
Only took Raven to the trial today. Cypher is having a break fo a weekend or two. I had entered Raven in a couple of runs and decided to play it by ear. She was certainly well enough today so we went – it was an afternoon trial again. Her Masters Agility run confirmed how much better she was feeling – she broke her start!!! Wasn’t a full on blast past me or anything but enough to creep up to the first bar and then knock it of course…so we finished the course anyway I could tell she was enjoying herself. We did a ripper run in Open Agility, again I can’t quite help feeling incredibly lucky every time I run her now. I have to smile as we get to have another go. She ran perfectly and with more of her old speed which led to me being too late with the out command on the distance challenge. We copped a refusal but that was our only fault. I was more than happy and grateful for the glimpse of the old Raven. Her lymph nodes (I felt them today) are now more the size of the stone in a small peach which is great. Her appetite still good (fresh cooked bacon for the trial today) and things are looking normal. She’s harrassing her back left toes lately, I think the itchiness is creeping back in, keeping a close eye on it. Back in to Murdoch tomorrow for treatment #3.
I had fun running my other two borrowed dogs today – Dexter, another Rhonabwy BC, in Excellent Jumping for a clear round and first place, his owner Janice was wrapt and then Rumour, the Sheltie, she was a bit put out by the minimal warm up but we finished off clear for not a bad run.
We now have a break, long weekend next weekend which is trial-less and then the next one is on June 10th Sunday. That’s the weekend Raven gets a week off from treatment on Monday (meaning the long weekend she gets the most toxic drug in her treatment) . I’m now looking ahead to that treatment hoping fervently that she, in her true Raven toughness, experiences no toxicity to this one. We can but hope.
Well here they are – Cypher’s first progeny. Born April 23rd to a dam called Angel (Oodnadatta Shes An Angel). Three boys and three girls. They are 4 weeks old in the photos below taken today. I definitely got my puppy fix in and fell in love with girl number 1. We’ll go back and get some more photos when they are around 6 or 7 weeks – if anyone is looking for a puppy right now let me know and I’ll put you onto their breeder, Nadine.
TNS Research Update Report
21 May 2007
The donations in 2006 to TNS research from the Border Collie Clubs of NSW, Vic and Qld and several generous breeders from Australia and US came at a critical time and has allowed us to continue the work which has identified the TNS gene and found what appears to be the mutation responsible for the disease. This work was not possible without the samples from litters with affected pups that were provided by breeders. The enthusiastic work of breeders to spread the word about the problem and the research has led to the attraction of funds from the UK Pastoral Breed Health Foundation which had set aside funds to support genetic research in working dogs. Together these funds have allowed us to make rapid progress toward our main aim, which was to identify the TNS mutation, and to examine its distribution in Border Collies around the world.The funding has provided the consumables we need to do the lab work and the PBHF funds provide a PhD Scholarship for Jeremy Shearman, which now allows him to work full time on the project. The support has allowed him to examine nearly all of the TNS gene in 2 TNS affected dogs and 2 carriers and several controls in just 6 months. He has tested about 30,000 DNA bases that make up the functional part of the TNS gene and has found what appears to be the mutation that causes the disease. We need to confirm this by showing that the mutation exists in the large number of affecteds and carriers that we have already tested, and not in unrelated unaffected dogs. To do this we need to develop acost effective, efficient test for the mutation. Once we have shown that this DNA difference is the cause of TNS in all known carriers, we will check that all of the dogs predicted to carry the mutated TNS gene by our previous test examining segregation of chromosomes in TNS related animals is 100% accurate.
We will also screen samples that showed no sign of TNS to confirm that no other chromosome types also carry the TNS mutation.The identification of what is very likely the TNS mutation means that we can now test any dog for TNS. Dogs to be tested no longer have to be related to knownTNS carriers. Information on samples submitted for testing and test results are kept confidential by us and owners are encouraged to publish their resultson the Border Collie Health web site. This means that not all of the test results are generally available yet.This good news of identifying the TNS mutation is well timed as it balances the bad news that the application for funding of this research through an ARCLinkage Grant was not successful.
We will continue to rely on donations and funds raised from our DNA testing to fund further research in Border Collies andother breeds.Since February, we have typed 800 samples to reveal 180 carriers and 2affecteds. Twenty-one of the carriers were from recent litters. We haveidentified 7 carriers from English ISDS lines to date. This supports theunconfirmed TNS cases from ISDS lines on the Border Collie Health Website astrue TNS. It also indicates the mutation is very old and has been around in thebreed for a very long time.Testing has been difficult on a small proportion of samples. This has led to asmall number of revisions of preliminary test results. Some buccal swabs do notprovide enough DNA for testing and so blood samples are preferred. Poor qualityof sample leads to delays in results and are much more likely to produce errors.It is hoped that the new test being developed will allow testing of even thepoor samples that have been submitted.Any samples will now be accepted for TNS testing at UNSW. Forms are availableon the Border Collie Health website, htttp://bordercolliehealth.com , on theTNS page. Once samples arrive in the lab it takes two to three weeks to enterdetails into the database, run tests, and send out results by email, so plantesting accordingly. The preferred sample locally is blood in EDTA tubes whichmust be packaged properly to send in the mail. Blood on FTA cards is moreconvenient for international samples. Mouth swabs can be sent from puppies atjust a few days old but a proportion (~10%) of swabs do not work so resultscannot be guaranteed and duplicate swabs are recommended.
DNA testing of genetic diseases such as TNS, allows breeders to continue to usecarrier animals in matings (if mated to TNS clear animals) and test the progenyfor carrier status. This means no desired breeding lines need be lost andbreeders can still select the best puppies to keep for breeding without anyfurther risk of producing TNS affected animals. Over a period of severalgenerations the disease can be eliminated from the breed by testing and selectedbreeding. Then testing will be no longer necessary. TNS is inherited as arecessive disorder like CL and CEA. If both parents are tested clear of TNSthen their progeny must be also free of the TNS mutation. In matings where oneparent is a TNS carrier, about half of the pups, on average, can be expected tobe carriers. In some litters all pups will be carriers and in others none willbe, but each pup has a 50:50 chance of being a carrier if one parent is. Foreach puppy from matings between two carriers, there is a 1 in 4 chance it willbe affected, a 1 in 4 chance it will be clear of TNS, and a 1 in 2 chance itwill be a carrier. But such matings can result in any combination of affected,carrier and normal pups. For example, one litter had 4 affected, 3 carriers and1 clear puppy.
TNS has most likely been in the Border Collie breed since it originated as itoccurs in several lines that are only distantly related. It occurs in show dogsoriginating from Australia/New Zealand, in pure English working dogs and inAustralian working dogs that are unrelated to the show dogs. The disease canpresent as very different symptoms from one affected litter to another which hasmade it difficult to recognise as a genetic problem. It is probably the majorcause of “fading” or “failing” puppies. Now a DNA test exists there shouldnever be another puppy affected by TNS and eventually TNS can be eliminatedfrom the breed. The purpose of this research, undertaken at University of NewSouth Wales in Sydney, has been to assist breeders improve the health andwelfare of the dogs. A side benefit is that the research could also assist inthe knowledge and treatment of the disease in human patients.Testing is currently only available at UNSW where the TNS and CL tests have beendeveloped. The research into developing a more widely available TNS test anddetermining the prevalence of TNS in the breeding population continues to bedone by PhD student, Jeremy Shearman. Without the support of the breeders andowners, the amazing progress Jeremy has made in a short time would not have beenpossible and his work could not continue.
PhDSenior Lecturer in Genetics
Head of Canine Research Lab
Here we are at Wednesday, a week and a half after Raven’s diagnosis. So far I am very pleased with how she is going, there’s room for even more progress but that would be like a lottery win I think. She had her 2nd chemotherapy treatment Monday. I took her into work on Monday morning, the kids were very impressed. She lay up the front of the classroom on her blanket whilst I was teaching. From time to time she’d wander around seeking some pats from many willing hands. I took her into Murdoch straight after that and filled in her weekly update chart this covered whether she had an episodes of vomiting, diarrhea, appetite reduction, lethargy or sleepiness levels plus her weight (I also had typed up a one page report of how she went during the week, based on her general well being, diet and exercise). The nurse who checked her in spoke to me as I asked a few more questions. I found out that her Lymphoma is B-Cell type so that was good (it is the one that responds better to chemo rather than the T-Cell type) and that when they take her blood that morning before treatment they check her white blood cell count and hope that it is around 2. The nurse said if it was 1.9 or 1.8 then it would be up to Ken Wyatt’s discretion as to whether they push ahead with treatment. So I left her there around 10.30am with the promise that I would be seeing her at 3.30 to pick her up. She didn’t like being left there, definitely wanted to walk out the door with me, but eventually she went with the nurse on lead without causing too much fuss.
He had asked how she went exercise wise and I told him that she had come to training with me both nights and done a few jumps and a simple course. I explained that we had been to Geraldton on the weekend and that she had originally been entered in 8 runs, 4 on the Saturday and 4 on the Sunday. I scratched her from 3 of the runs each day and took her out to do one run in the Masters Agility class each day. I figured if she wanted to have a go she could, she had been rather frustrated watching Cypher do his runs, so I surmised that if she felt well enough and wanted to run with me we’d have a turn. I am becoming more and more convinced that the positive and optimistic attitude towards her health that will help her overcome this includes her being able to participate and enjoy her life as she normally does and with agility always being such a big part of her life I truly believe she would definitely feel that something was amiss or wrong if she couldn’t still partake in this activity that has been a huge part of her weekly routine. So we lined up on the start line and before I’d even given her the OK to go I found myself just smiling at her like an idiot thinking how lucky I was to be able to share this with her. We took it easy and she seemed to do the same, I handled her in a much more laid back fashion than usual. My relaxed attitude nearly contributed to an off course and caused a very wide turn but by the end she was flying in front of me and we finished the course clear for 5th place. She was having a ball! She got a whole egg out of my bacon and egg toastie for her jackpot and she thought that was great! She was fine after the run, certainly not too tired to stop barking instructions to Cypher round his next few runs! The next day we had another go at Masters Agility, she had travelled very well, slept well and was eating like a horse so I figured she was up for it. We had a couple of wobbles round the course, she got stuck at the end of the chute, weaver entry had a slight glitch but I was just having a ball running her cherishing every second. She ran clear again for 4th place this time just behind Nifty, Jess and Terra. It’s amazing, whilst my handling was far from exact and sharp, I was just so relaxed, not caring if we ran clear or not it seems to have added an element of control that is sometimes missing from our runs! She was really responsive and tuned in. I was so glad I had made the long drive, despite Cypher having weave pole issues all weekend. At least he managed two clear very nice runs in Open and Masters Jumping at the end.
So the nurse was happy to hear that she had felt well enough to be active on the weekend and he kept my report in her file.
I returned at 3.30pm to pick her up and this time a different nurse came and discharged her. She came out with her bum wriggling and tail going madly very happy to see me. She looked no different from when I dropped her off apart from being happy now and having a small patch on her other front leg shaved. The nurse told me it had all gone well; she had the treatment fine and was ready to go home. I asked about the blood test and her white blood cell count and he told me it was low but Ken had decided she was fit enough for treatment. I asked how low and the answer came back – 1.4. Internally I was a bit alarmed at this recalling what the Nurse had said that morning, and basically said “Wow and he still did treatment!?!” The Nurse nodded and said Ken obviously felt that she was fit and healthy enough to take that risk. Which I was glad for because otherwise her treatment plan would have been delayed by a week but I was still surprised. I emailed Ken the next day asking about it. He agreed that he had made a judgement call based on the fact that he thought she was doing well (lymph nodes have reduced somewhat and she had gained 0.3 of a kilo) but also that my concerns about her being more susceptible to infections should not be too deep because the length time the WBC is low for means in general, infection cannot take hold. The only problem might arise from bacteria that already exists in the gut and that I should let him know straight away if she has any appetite reduction or is more sleepy than usual. So I took her home and she seemed a little tired but nothing out of the ordinary. She had a slight episode of upchuck of some yellow bile at around 7.30pm but that was it and an hour later was busy getting a good sized meal down her. She slept the whole night through Monday night and was toileting normally. So far that little episode is the only evidence of the chemo treatment.
I of course have still been scanning, browsing and reading lots of information and I also emailed Ken asking about the creditability of some of the documents I had come across.
I had found some very interesting reading from the World Small Animal Veterinary Congress held in Prague last year 2006. Check this page for a few the of latest findings and theories;
I have a list of questions to email Ken with now (I am trying to space my emails out so I don’t seem like a completely neurotic dog owner!). I emailed Ken initially with the following question; Should I or can I give her additional Arginine supplements (at the moment her sources would only be poultry and seafood – sardines and tuna) as well can extra Glutamine and Cysteine be given?
I had read in the documents at the website a study or two had suggested positive findings with regards to the use of these supplements. Ken replied (very promptly!) that the author of the papers was well respected and whilst the information he provides has logic currently there is very little evidence (simply due to lack of studies) to back it up. That said he also stated that it would do no harm to give these supplements at 1/3 the dosage on the bottles. So I am looking into purchasing these supplements right now.
My other questions that I need to pose include;
- Can Raven’s serum levels of docosahexaenoic acid be tested to see if they are elevated? That way I will know if the supplementation I am currently giving with the n-3 fatty acids (in the form of fish oil capsules) is working. It also helps with lowering her plasma lactate levels.
- When she enters remission will her lactate and insulin levels decrease to normal levels? These levels are a major part of what causes her to feel tired right now when exercising.
- Should I give Trimethoprim/sulfadiazine to reduce her GI toxicity when she needs to have the doxorubicin treatment? (This drug is the most toxic of the four drugs in her protocol)
- And the most serious/biggest implication question for Ken; does he think that the autologous bone marrow support that allows chemotherapy dose intensification would be worth doing given the increased toxicity risks?
That last one is critical, everything I have read about the treatment of transferring bone marrow has so far been definite that the chances of cure and longer remissions are far greater than without the bone marrow support. It sounds like a drastic procedure and the toxic effects can be far greater due to the much higher dosage of chemotherapy. It is something we have to seriously think about and probably enter into long discussions about between ourselves and with Ken. So far I am highly impressed with the treatment both myself and Raven has received at Murdoch. The Nurses and the doctors (both Ken Wyatt and the intern Amy Lane) have been nothing but patient and absolutely on the ball with all queries and concerns. Their prognosis, whilst guarded, is undeniably positive and their attitude is optimistic. This had helped alleviate my concerns considerably knowing that Raven is in good hands when I leave her there each Monday.
So that is where we are currently at, as I mentioned we’d have won the lottery if all signs of the cancer immediately disappeared and she was on her way to a confirmed cure however all things considered I feel she is doing very well. Her lymph nodes have decreased in size, she has put weight on, she is not experiencing toxicity from the treatments. I’d really like to see her WBC back to a more normal 2 next week but we shall see. She has the Vincristine again next Monday, then the doxorubicin the following Monday.They do not do a test to confirm remission until her 9th treatment, and thankfully (because whilst I know biopsies are not a big deal I still feel an aversion to them) they only need do an Node Aspirate where they take a sample of cells from the lymph nodes via a needle to test for the presence of cancer cells.
I’d just like to say a word of thanks to all those people who have emailed, messaged, left messages here – it means a lot to know that so many people are wishing for a positive outcome for my girl. If psychic vibes play any part she is well on her way to beating this cancer!
Stay tuned for the next update!
Well so far so good. It’s Thursday, 4 days after Raven’s first treatment last Monday. So far the only side effects I have noticed is on Monday night her increased frequency of urination and pooping. All outside thankfully, though I did not get much sleep that night! I am sleeping in our lounge at the moment so that if she needs to go it’s not far for me to stumble out of bed still half a sleep to let her out. Monday night that was about 5 times. Tuesday night only once and then last night we slept the whole night through. She is still eating and drinking well, no signs of vomiting at all. She was semi off her food a bit on Tuesday night and Wednesday morning – but she was back to demolishing a chicken frame Wednesday afternoon. She is experiencing a some soft stools at the moment but nothing too excessive. We go back in on Monday and work has decided to be flexible, I can take her between teaching classes. She will have a repeat blood test every time before they do the chemo.
As for her activity she is still running to the door each time one of us arrives home, insisting on being at the door before I left for training both nights and was even feeling up to doing some light training over a simple course and a few jumps. Feeling good enough to have her usual barking at me over jumps happening. She’s lapping up the attention though I have to say….I’m thinking she’ll be milking it too very soon! She’s not silly, she’ll figure out pretty quick that if she looks attentive enough and nudges a pocket insistently then she’s pretty much got it in the bag treats wise. Diet wise she’s still enjoying her raw BARF patties, veggie mash, yogurt and chicken frames, turkey wings are on the menu in the next couple of days too. I do have to say though, in the way of training treats for dogs there’s really not a whole heap of ‘healthy’ options out there that still gets the kind of ‘will do handstands to have’ kind of mentality. There is such a lot of garbage in frankfurts, chicken roll, chunkers, pre cooked sausages of ANY kind. Four Legs is not bad ingredient wise but that coconut gets everywhere and plus pasta is one of the main ingredients and I can’t use carbs on Raven, not a whole heap anyway. I’d like to keep the raw meat for dinner time rather than training. Anyone else know of a really quick convenient healthy but tasty option for training treats (not counting cheese) that doesn’t involve a whole heap of chemicals or carbs??? Yes I can cook up liver and chop that up, and I do on occasion but even that is time consuming and smelly for the kitchen I have to say!
GREAT NEWS! Raven’s bone marrow came back clear of cancer along with her blood test, so her marrow and blood are still very much cancer free YAY!
She is lying at my feet on her favourite Snooza Pet Futon, feeling very drowsy and tired but contented to be home. The other two youngsters Cypher and Spryte are sniffing at the door wondering what’s going on but Raven deserves some peace and quiet right now.
The nurse who discharged her, Amy, gave us two lots of drugs to take with us just in case. One is if she has some mild nausea and the other is for more serious vomiting. She said 1 in 5 dogs will show some side effects but it is not very common at all. Her first drug in her chemo treatment was Vincristine and they inject it via a catheter. All her treatments will be via a catheter due to the risk of even a tiny drop not going where it should. She will go back next Monday for her 2nd treatment. She goes once a week for four weeks then one week off. This continues for 16 treatments. So far so good. I will see if she is interested in food tonight and give her a half or quarter meal. But other than giving her time to sleep off the sedation effects of her marrow test and ensuring she can let me know when she needs to go outside or have a drink there is not a lot more that I can be doing right now. We will know within 4 days whether or not she tolerates this drug well as the nurse said it can take up to 4 days for any side effects to develop. We’ve got the first win done so hopefully this second one will happen as well.