Jewel's Cancer Journey Part 1 - Epitheliotropic
Cutaneous Lymphoma (T-Cell)
Pre-Diagnosis/Symptoms
I got the call on May 19, 2017. I was at work and the moment is
frozen in time...and seared into my memory.
The vet told me the definitive diagnosis and it was something I could
not spell or pronounce. I had to have
her say it a few times: Epitheliotropic
Cutaneous Lymphoma (T-Cell). One is
never prepared for this, and myself even less-so.
We had just adopted Jewel 2 years earlier - and she had
just started living life! She and I had
just begun volunteering as a Pet Therapy team.
She had come such a long way from the scared skittish pup we had met 2
years before. She had always been so
loving, and she was just coming into her own.
The cruel fate of it all. And,
on top of that, I had lost my prior amazing big goofy golden retriever to
cancer (malignant melanoma of the mouth) 9 months prior – and…I had lost my
mother only a few short months before that.
We were going to push for as much as we could get - and
live life to the fullest - and NOT go
gently into that good night. This
was our mission, and I do believe it was accomplished.
There is very little information on this specific kind of
cancer out there, so this is one of the reasons I'm writing about this. Hopefully, Jewel's story will help someone
out there who might be going through the same journey. My hope is that it can maybe help others come
to a diagnosis more quickly than we did.
Summary of Key Initial Symptoms:
·
Gradual loss of pigment around eyes, followed by
loss of pigment in jowls and under nose.
Eventually, no pigment at all in these areas. Nose also became very slightly a lighter
shade.
·
Dermatitis, small sores that don’t seem to
itch. Will not go away with traditional
skin treatments.
·
Progression of sores, becoming larger and more
prevalent, starting out red, then becoming flakey, when skin flakes off – the area
bleeds – and fur eventually comes off with the flaking. Eventually sores progress to ulcerated stage.
·
Initially low WBC count several months before
other symptoms, followed by elevated counts after other symptoms. Eventually WBC levels super high.
·
Elevated liver levels – gradually rising over
time. Eventually, a very high spike in
liver levels.
·
Difficulty swallowing (later stage of
symptoms). Coughing and spitting up
water and undigested food just after drinking.
·
UTI/bladder infection – just prior to diagnosis.
Time from initial symptoms to diagnosis:
·
Approximately 8 months (from start of loss of
pigment), but low WBC count was indicated about 9 months prior to any other
symptoms.
Symptom
Progression
Backtrack to September 2016
·
The first symptom we noticed around this time was
that the pigment around Jewel's eyes was starting to disappear - seemingly
overnight. Jewel previously had black
pigment on her face, mouth and jowls. We
noticed that her once full black eyeliner was disappearing, leaving a few black
spots/flecks behind. The black spots
would change over time, disappearing in some areas and appearing in others.
·
Gradually over the next few months, the pigment
disappeared from her mouth, jowls and under her nose. We would notice very sudden changes, although
it was likely more gradual. In looking back
at photos, the change is very striking.
Late November 2016
·
We had a vet appointment and discussed these
changes. Our vet suspected a skin allergy
and she wanted to keep a close eye on it.
Also, Jewel had always had dermatitis...and the vet around this time
noticed that her rash seemed to be a little worse than normal.
January 2017
·
We were in for a follow up vet appointment, and
it was noticed that Jewel's white cell count was elevated. This especially was of concern because in the
past, Jewel's WBC levels were always below normal - to the point that we did a
re-test at one point to determine if the low levels were her “normal” - and it
was chalked up to that being the case.
So when they had elevated to a higher level than a normal dog's
"normal" - this did raise concern.
February 2017
·
While this was going on, Jewel's skin continued
to lose pigment - and now she had virtually no pigment on her face. In addition, the dark pigment spot that Jewel
always had on her tongue also had disappeared.
·
Her skin continued to have irritation and
rashes. But the weird thing was that
they didn't seem to bother her. She
wasn't scratching them, and they didn't seem itchy. The rash was mostly on her belly, but likely
all over her in other places that we couldn't visibly see, as well. Small circles the size of a penny or nickel...some
getting a bit larger. They started out
as brighter red spots, then the skin would flake...and if it fell off, it would
cause a small open lesion.
March 2017
·
We took Jewel in for her standard annual checkup,
and it was then discovered through regular testing that her liver enzymes were
elevated. They were still within normal
range, but they were on the high end.
·
We also discussed her worsening skin problem - and
the vet recommended two things: tramadol
for the rash and antibiotics. Jewel
historically was averse to antibiotics, so we opted for a bathing regimen
instead. We bathed her every 2 days for
3 weeks straight with a special shampoo.
April 2017
·
On our follow up visit, her liver levels had
increased again (but not yet to an alarming state) - and it was noted that the
tramadol had not done any good - and her sores were continuing to progress.
·
The next protocol was to put her on a special
liver diet - Hill's Liver L/D. She hated
this dog food, but tolerated it to an extent.
Mid-April 2017
·
In mid-April, Jewel started having issues with
keeping her food and water down. She
would drink a lot, then immediately choke and spit up some of the water. She also did this immediately after eating
her food - with fresh undigested food coming up with the water. This happened almost every time she ate or
drank.
·
Jewel started showing signs that she wasn't
feeling well...while our hunt for a diagnosis continued. This was one of the most frustrating
things. We knew something major was
going on and had no clue what it could be.
I had been researching a lot online, and nothing seemed to fit with her
exact symptoms. I suspected she was
suffering from an autoimmune disease that I had researched, however, she was
not exhibiting the exact symptoms of that disease....and the vet was not
convinced, either.
May 2017
·
This was the most challenging month - as Jewel
began to crash while I was out of town for 10 days. She had been holding steady before I left on
my trip, however over the course of those 10 days, she suffered a sudden
downturn. She was continuing to have
trouble eating her food, and had lost weight.
In addition, she was having accidents in the house, and generally did
not look well.
·
The last 2 days of my trip - she didn't want to
eat. At this point, she was rushed to
the vet for immediate care. She was
given IV fluids, and it was determined she had a bladder infection. Her liver levels were off the charts and her
white blood cell count was astronomical.
While I was gone she had developed a lot more lesions on her body, as
well.
·
She was put on heavy antibiotics and biopsies
were taken from a few of her sores.
After getting the IV and antibiotics, she had a very quick turnaround to
the immediate issue of the bladder infection and started feeling much
better. But the rest of her symptoms
were still there.
Then, after waiting for a few days...we got the call on
May 19, 2017. We knew we had a tough
journey ahead of us - and I was willing to give her every fighting chance. The prognosis for this kind of cancer after
diagnosis is only from 1-2 months up to around 6 months. However, in rare cases it can be much
longer.
This cancer is so rare, it lead to many months of not
having a diagnosis. My vet had only seen
this cancer once in her career, and it was not even with a patient of hers...it
was her neighbor’s dog.
A few side-notes of things that we noticed in retrospect
are listed below. These things may or
may not have anything to do with her getting cancer – but worthy of sharing in
case there is any connection…
·
In June 2015 - Jewel had two small-ish growths
on each of her back feet that were surgically removed – close to her foot pads. Neither growth was found to be cancerous at
the time, and they both were different things.
One was some sort of growth due to an allergic reaction...and I can't
recall what the second one was.
·
She lived in a back yard for years before I
adopted her - exposed to the elements. She
always had a fair amount of dermatitis - and this could have been linked to
years of being outside. There have been some studies that link years
of untreated skin allergies to be a precursor to this kind of cancer.
·
Also a little after we started seeing pigment
changes, she had a severe allergic reaction after rolling in the grass...her
whole body was blotchy and her face swelled up.
We gave her Benadryl and it subsided, but it was strange. This happened right after she rolled in fresh
cut grass. And boy did she like
grass! She ate it all of the time -
loved the taste. But maybe she was
allergic?
Also, I started using a Mosquito spraying service in October 2015. Knowing what I know now - I would not have used this kind of service. It’s supposedly "safe" for pets after it dries, however, I have since learned that it is suspected of being toxic, and on top of that – it doesn’t just kill mosquitoes, it kills many beneficial insects like bees and butterflies. I stopped using the service in October 2016 - after using it for several months prior (after a break in the winter). I have guilt over this, as I suspect it didn't help matters. She was eating that grass and rolling in it all the time.
