My journey with Hossa
End of 2019 and throughout all of 2020 was a helluva year but 2021 has not been a walk in the park either. Though I was desperately hoping it would be, as was everyone else I'm sure.
Since about the middle of 2020, I've been working as a vet tech at Banfield in Arizona. And if you know anything about the world of vet-med, then you know it doesn't pay a lot but the work is very demanding. Which is fine, I was up for the challenge and it was something new for me. But then at the beginning of 2021 after Hossa got his dental/teeth cleaning in January, he started acting weird. He was getting worn out considerably more than usual during his normal activities and he was also peeing in the house. Which is completely unlike him. I took him into work and ran tests but they all came back normal.
We tried a couple different medicines, but nothing seemed to be helping with him peeing in the house. So finally I decided to just run his bloodwork because something didn't feel right about the situation even though less than a month ago during his dental his bloodwork had been normal.
His calcium was elevated significantly. Hypercalcemia.
We looked at his food, his treats, etc but nothing raised any red flags. We threw out all his old food and buy him new and monitor him for a week afterward to see if it helped.
Nothing - no change. We ran some additional tests to see if it was potentially something more serious like kidney disease/failure or cancer. The original test that we sent out was the wrong sample, and took a week to find out that it was the wrong sample. So we send out another sample for a PTH test, parathyroid hormone which essential regulates calcium, but when elevated it can indicate a tumor on the parathyroid gland.
Hossa's PTH test came back elevated. Which potentially indicated a tumor on his parathyroid. Of course I panicked. My dog potentially has a tumor or cancer? Cancer?! But he's not even 5 years old yet, how can this be? The doctors told me there were several other tests that we can run still. The other option is to run a PTHrP, which is the parathyroid hormone relate protein test. This test checked for proteins that can help determine if it truly was cancer or a tumor. Basically, if the PTHrP is low, there's no cancer or tumor indicated. But if it's also high like the PTH test, then there's a good chance it's cancer.
We sent out a PTHrP as soon as we could. We sent multiple samples because it wasn't clear which colored tube they would need. Plasma vs serum. Frozen vs refrigerated. But we sent it all. A week later we got a notice that none of the samples were viable. How? I'll never know, we sent several. Hossa was coming to work with me everyday at this point because of how frequently he had to pee due to the hypercalcemia, so it made it easy to grab samples whenever we needed. But once we found out they needed a new sample, we sent one out immediately.
About 10 days later, we finally got the results back. The PTHrP came back as 0, which showed a normal result.
What a relief! It isn't cancer.
But then what is going on with Hossa? We still had no idea.
My next day into work, I chatted with the vets to see what else could be going on. None of us had any idea. We decided to send out a full thyroid panel, a Valley Fever test and retest his kidney values. It took a few days for the thyroid panel to come back but they were all negative, as was the kidney value test. A couple days later, maybe four days, another test result comes in for PTHrP. This one was elevated. This test would mean Hossa has cancer. But which one was right? The first test or the second? Our vet immediately got on the phone with the laboratory who did the test, but it wasn't clear to them which one was right?
Are you freakin' kidding me? They didn't know which test is right? I stayed on top of my team to find an answer, they were probably so irritated with me, I even asked my manager to give them a call to find out which test was right. But I didn't have a good feeling about it.
My last saving grace was the Valley Fever test. Maybe if that was positive, it could be the answer to everything. Maybe.
That came back negative too.
And the second PTHrP test was correct. The elevated one.
The one that indicated cancer.
The next couple days were a blur of crying.
Honestly, trying to recall most of this was hard. It spanned weeks but it all felt like a blur. I was so stressed. I'm still stressed.
Finally, we had somewhat of a direction even though it really sucked and the last thing I ever wanted for Hossa was cancer. But at least we could finally move forward. We got the news of his PTHrP test on March 31. And in the middle of all of this happening, I took a new (old) job on March 29. So I was working 3 days a week at this new job and then 2-4 days at Banfield depending on the schedule.
Anyway, my mom was my saving grace during all of this because while I was at work she was calling the Internal Medicine and Oncology centers that are all around the Phoenix Valley to see if we could get an earlier appointment for Hossa. Within a couple days of her calling she was able to move it up to May 13. Then she got May 6. She got it moved up so quickly and she would have continued calling several times a day.
However, my manager at Banfield was able to get us an appointment with the Internal Medicine center on April 6 to do an exam and ultrasound and potentially biopsy his lymph nodes. After we got to see the internal medicine doctor and they did all his tests, they said they didn't see anything during his ultrasound and they weren't able to obtain any viable samples from any of his lymph nodes but they did sample his spleen so hopefully that would provide some answers. But basically, I was told that I just needed to wait because we probably caught it so early that it's not going to show up right now.
What kind of medical advice is that?
"Just wait for the cancer to get worse, so we can find it."
A few days later we got a call that the splenic biopsy didn't show anything outstanding, ie no cancer indicated. But the reality was that it was still cancer and our next step would be to do a CT scan, a bone marrow biopsy or remove a toe that we thought could have been cancerous. After about a week of chatting with my vets at Banfield, we decided to do the bone marrow biopsy. We made an appointment for April 22 to get his bone marrow biopsy done.
On the day of the appointment, they also quoted us for a CT scan as well in case the bone marrow biopsy didn't show anything so we would know our next step. They had an opportunity to come up to get the CT and bone marrow done in the same day, so we jumped on it. Because we knew we would get an answer one way or another that day and we needed a definitive answer in order to be seen by an oncologist. Which is still the stupidest thing ever. We had several tests that pointed to cancer but they needed more.
About four hours after we dropped him off, the vet called me because they had completed the CT scan and there was no need to do the bone marrow biopsy.
They found a mass.
A mass in his chest.
Hossa isn't even 5 years old yet.
We had been driving, I pulled over and we cried. My mom and I.
They called it Mediastinal Lymphoma. His mass. It's typically t-cell, which is worse than b-cell. They told me that even with Chemotherapy, I may only have 3-6 months with Hossa. But they scheduled us an appointment to see the oncologist but it wasn't going to be until the end of May.
We took a couple days to enjoy uninterrupted time with Hossa and to cope with the news. We drove to Sedona and spent the day among the red rocks. We also drove to Payson and looked out over the Mogollon Rim the next day. Even though I was filled with sadness, we still had a good couple days. It inspired me to start taking more pictures of Hossa and I together. Because I don't have enough and even if I had started when he was 9 weeks old, it will never be enough.
Before we left for the weekend, my manager said that she had a working relationship with another vet at a different oncology center in Phoenix and would give her a call for me. After the weekend away, my mom immediately set to work again and I called the oncologist that my manager had referred me to. There was no way we were going to wait until the end of May to see an oncologist. It had already taken us well over a month to even get to this point and there was too much on the line. Within the day, she had the appointment moved up from the very end of May to May 13. And by April 26, I had heard back from the oncologist I called.
They could get us in that week.
So, I took it immediately and cried with relief.
I've been crying a lot.
Dr. Hershey saw Hossa on April 29, just one week after his CT scan and gave us the run down of everything. The cost, which would be about $7,500 total for all 20 something of his treatments. And that it was definitely Mediastinal Lymphoma, but she felt confident that he would be a good candidate for chemotherapy. She didn't think he would have survived to the appointment in late May. Maybe not even to the May 13.
Hossa started chemotherapy that day - April 29.
I am eternally grateful to my Banfield staff for helping in every way they could.
Grateful to Dr. Hershey who took Hossa in almost immediately. She has a soft spot for Giant Schnauzers as she used to be owned by one too.
I am grateful that I still have my heart dog.
So that almost catches us up to today.
Hossa had his 4th chemo treatment this past Thursday, May 27th. Next week is his rest week between his CHOP chemo treatments and then the week after we will take x-rays to see if the cancer is responding to chemo. Hopefully we'll have more answers soon. If you read this all the way to the end, wow, thank you. It's been a long time since I've done any blogs, but I know there's been quite a few people that have been curious about his journey through all of this. This was pretty hard for me to recall, I've been stressed non-stop since mid-March.
I'll update again soon.