Can The Bulldog Be Saved?

Today's Sunday NY Times magazine  (Nov. 27, 2011) features a cover story about the bulldog and the ways in which the breeding for flat face and stubby body has produced a dog with a shortened lifespan (average 6.5 years) and multiple health issues including brain tumors, congenital heart disease, hip dysplasia, lymphoma, and more. The article focuses solely on the larger bulldog (often referred to as the English Bulldog) but many of the health issues discussed can occur in the French Bulldog.

link: (note: you may need a Times subscription to read the entire article)
http://www.nytimes.com/2011/11/27/magazine/can-the-bulldog-be-saved.html?_r=1&ref=magazine

Bosco's Story Pt II - The disease and learning to live with it

Back in New York my goal was to get as much information on the most effective treatment options available for Bosco, and quickly. The neurologist in CA had explained that untreated the life expectancy of a dog with a brain tumor was estimated at between 64 and 307 days. We were in a race against time.

Living in NY for the past 9 years I had frequently heard that the Animal Medical Clinic in Manhattan was considered among the best places one could take a pet, that as a veterinarian teaching hospital it would have the most up to date treatments. My California neurologist, Dr Campbell, had given me a referral to a neurologist there, a Dr. Chad West, who had been a classmate of hers.

But our visit to the Animal Medical Clinic was a huge disappointment. After an intake with a resident, Dr. West entered the examining room and, leaning against a far counter stated flatly that a brain tumor was incurable - something I'd already been told in CA - and the best I could do would be to give Bosco palliative care, meaning keep him as comfortable as possible with medications and wait for the tumor to kill him. The fact that he didn't lean down to touch Bosco, much less examine him, was the antithesis of what I'd experienced in CA, where doctors had shown genuine concern and promised to contact UC Davis Veterinary Hospital to inquire about radiation and other therapies.

I had already requested that the CA clinic forward Bosco's MRI images and records to the Animal Medical Clinic, so even though I already was having doubts about his commitment to Bosco's care, I asked Dr West if he would review them and offer his opinion on Bosco's options. He said he would discuss them with the oncologist on staff. Yet, after several unreturned phone calls and emails - other than one email acknowledging that they'd received the MRI images and records - I never heard back from Dr. West. This futile attempt at clarifying our options had consumed a week and a half and we were back where we started, no closer to answering the question "What can I do for my little companion?"

Below is a webpage with a primer on tumors in dogs and cats

http://ezinearticles.com/?Brain-Tumors-in-Dogs-and-Cats&id=515354

Meanwhile, Bosco and I were attempting to get through each day with his new needs, especially his frequent peeing. The steroid prednisone seemed to have erased all of the house training he'd learned as a puppy and taken away his bladder control. It was clear he needed to wear doggie diapers. Traveling to PetCo used to be a fun trip, Bosco could come along and we'd get him treats, a new leash, a toy, or whatever felt right. But walking into the store to buy doggie diapers was a very different experience and once purchased, getting the damned things to stay on his little tailless rump was an even bigger challenge, with him walking out of them most of the time and having "accidents". As the days passed I got used to the process and anytime he'd glance toward the back door, I'd rush him out to the garden. Nights were the hardest as he would notify me by jumping off the bed when he felt the urge to pee, prompting me to fly out of bed, throw on some clothes and get him down the stairs to the rear garden. This happened at least three times each night and made sleeping for more than an hour or two at a stretch pretty much impossible.

Dr. Campbell wanted Bosco to stay on the high dose of prednisone - two 5mg tablets a day, one in the morning, one at night - for several weeks in order to bring down the swelling in the brain caused by the tumor. The MRI images had been so shocking and I hoped desperately that the steroid would give him relief. Even though the medication brought other complications to both our lives, Bosco was stable. He was having no more seizures, was able to go for walks and to the park, and was eating heartily.

Meanwhile, my job was suffering from inattention, but what other options did I have? I arranged with my housemate to watch Bosco (and help keep his diapers on) for a few hours each day while I ran to my office, checked in with my colleagues and boss, and touched base with my various real estate sellers and buyers to ensure that deals were moving forward and properties were being shown. I hoped this arrangement would be a workable solution until my housemate had a meltdown a few days later when, exclaiming that the potential of Bosco having a seizure or needing emergency care while I was at work was too stressful and she couldn't be responsible for him. She demanded I hire a dog-walker to look after him or take him to doggie day care. I knew this was not a workable solution as Bosco needed much more attention than a healthy dog and it wasn't just a matter of having someone come in and take him out.

At this point I realized that New York was not offering Bosco any treatment for the tumor and that the idea of trying to work when he needed medication every 6-8 hours was impossible, so I made plans to return to California. I would farm out my real estate listings and in-contract deals to my colleagues in Brooklyn and commit myself to Bosco's treatment.

Bosco's story, Part II (back to NY)

Back in Brooklyn and tired, Sept. 2010. (front leg shaved from an i.v.)

Our flight back to NY was early the next day and Bosco and I stayed the night with a friend in Oakland. Bosco was on the new medication regimen prescribed by his neurologist Dr. Campbell at VCA - prednisone, a steroid to reduce swelling in the brain and phenobarbital to control seizures - and just as she had warned, he was peeing frequently and drinking more water. Because the prednisone causes the increased urination he was restless all night and I was up with him at 1:30, 3:00, 4:15 and 6 am, taking him in and out of the house to let him pee. But even with the frequent in and out he had "accidents" in the house. He seemed to have lost all of his house training, the drugs making him incontinent.

It was difficult enough having him urinate in a friend's house on an overnight stay but I began to dread returning to Brooklyn where I was sharing a house that belonged to a friend. I knew Bosco's illness and new requirements would complicate our housemate routine.

Bosco's behavior also began to change - he no longer lifted his leg to pee or mark a tree or squirt a hydrant like he'd always done - he now only squatted. And he seemed distant and low energy, no  more happy greeting dance when I'd come through the door. Where had my playful, affectionate little boy gone? What was this disease doing to his personality? Had his brain been damaged permanently by the swelling or were these changes side effects of the medications?

Over the next several days I would get the results of the spinal tap and blood panel from UC Davis Veterinary School - all tests for bacterial or viral causes were negative, leaving only a tumor as the possible cause for the seizures and swelling in his brain. Not at all what I wanted to hear - a diagnosis yes, but one with no cure or clear treatment. A glioma, the same type of brain cancer that struck Senator Ted Kennedy. So what now? What course would this disease take?

Fighting Canine Cancer

Just discovered a blog dedicated to canine cancer information, news about cancer treatments and recently FDA approved medications:

http://fightcaninecancer.wordpress.com/2009/06/18/new-hope-for-dogs-with-brain-tumors/

It was also inspired by the premature death of someone's bulldog, who's name was Georgia:

The mission of Georgia’s Legacy is to provide information and resource referral to others whose four-legged family members have been diagnosed with cancer.  Most of all, Georgia’s Legacy was created to provide hope and emotional support to those in the fight.

A few words on airlines and flying your pet

Since summer is here and folks will be traveling with their pets, here's a portion of an article entitled "Making the Skies Friendly for Pets" that ran in the NY Times Sunday Travel Section on May 18, 2011.


"Pet safety has also become a more pressing issue. Incidents of animals being lost, injured or dying have recently risen. Thirty-nine animals died while flying aboard commercial jets in the United States last year, compared with 22 in 2009, according to the Department of Transportation. Thirteen were injured and five were lost. Delta was responsible for a significant portion of the increase, with 16 deaths and 6 injuries in 2010, compared with 3 deaths and no injuries the previous year."


The article also discusses some of the fees airlines charge for "in-cabin or under seat" and "checked baggage or cargo" pet travel.


complete article:
http://travel.nytimes.com/2011/05/22/travel/what-to-know-when-traveling-with-your-pet-practical-traveler.html?scp=1&sq=making%20the%20skies%20friendly%20for%20pets&st=cse


* Note that brachycephalic (flat faced) breeds like French Bulldogs are never recommended for travel as "checked baggage or cargo" as they have a higher risk of health problems. If possible fly them "in cabin" so you can monitor their progress along the way. Most airlines have a weight limit of 20lbs including the carrier, but having traveled with my Frenchie who weighed 23lbs on his own, I know that as long as your dog can stand and move around inside your carrier, it doesn't seem to be a problem for the airlines - and they never weighed Bosco in the ten or so times that we flew domestically from coast to coast.

Shocking Statistics

From the French Bulldog Club of America's website:
http://frenchbulldogclub.org/helping-frenchies/how-your-dog-can-help-frenchies/brain-cancer-devons-story


Although the incidence of primary brain tumors in dogs is not high, being about 14.5 per 100,000 for dogs in general, there are four breeds that account for more than half of those cases:  Bulldogs, French Bulldogs, Boston Terriers and Boxers.  The other 157 AKC breeds (plus mixed breeds) account for the rest.  These pie charts illustrate this astonishing disparity between breeds.
A dog of one of those four breeds is 25 times as likely to develop brain cancer as any other dog.

Bosco's story, Part I

I begin this blog with the goal of sharing my experience of having a young French Bulldog diagnosed with a brain tumor. As a disclaimer I wish to make clear that I am not a veterinarian, dog breeder, dog expert or a medically trained person. I am simply a fan of the French Bulldog breed and would like this blog to be a forum where other Frenchie owners can comment and share their experiences. My own experience left me with so many questions - many still unanswered - and perhaps by sharing our stories with each other, this blog can become a source of information and support for those making their way through the difficult journey that is this tragic disease.

There have been two Frenchies in my life. The first, Omar, was a black brindle male (30lbs, he was a big boy!) who lived to be one month shy of his 13th birthday; the second, Bosco, a honey-pied male (23lbs, he was the sporty model!) was diagnosed with a brain tumor at age 4 yrs 5 months and died at age 4 yrs 10 months. It is my process of dealing with Bosco's illness that inspire this blog and I hope that these writings can assist those who may be going through this process with their dog.

Bosco

Omar

Discovering that your companion has a terminal illness is disorienting and heartbreaking in the extreme, especially if he/she is young. Added to the tragedy is that the diagnosis is only the beginning, as the journey you will take  - and like me, you will have very little choice but to take it - has many twists and turns as you attempt to gather and glean information, select treatment, manage medications, weigh the financial costs, and accept the impending loss of your sweet friend.

My own journey began with Bosco and I on vacation in Sonoma County, California. On a warm September night we had retired to bed, me propped up with pillows reading a novel, and Bosco settled into a comfy niche beside me. At four a.m. I was awakened by strange coughing and clicking sounds and sitting up could not locate Bosco. Getting out of bed I saw wet spots on the carpet, then a pile of excrement, and turning toward the hall, found Bosco looking wild-eyed, his ears pushed back in a distressed position and foaming at the mouth. In my confused disorientation I picked him up and put him out on the patio, thinking that I must first clean up the mess, but snapping out of my auto reflex, I turned back to take a closer look at him and noticed he was crouched, trembling and limping as he moved around. It was disturbing to witness my formerly healthy, energetic little fellow acting so wounded, helpless and confused.

Quickly searching online I found a local 24 hour pet emergency hospital (PetCare Veterinary Hospital in Santa Rosa) who said "Bring him in immediately." When we arrived they took us into an examining room, asking questions about what he may have eaten: "Were there mushrooms or moldy walnuts (highly toxic it turns out) or snail bait or any other poison in the garden or anywhere that he may have gotten into?" "Not that I know of" I replied but mentioned that at the beach the day before he had chewed up an empty crab shell, enjoying the crunch and activity of destruction, but spitting out the pieces. Could this have made him sick, I wondered?

   Crunchy Crab Tasting

Bosco stayed at the emergency clinic the rest of that night as the doctors monitored him. They called in the late morning to tell me that his fever had gone down as had his accelerated heart beat and that he had begun passing the charcoal formula they had given him to draw out any poisons. They would keep me posted on his progress and if all went well, I could pick him up later in the day.

Later that day I got another call, the doctor saying that they were concerned because as the anti-seizure medication they'd administered had worn off, Bosco had begun to have facial twitches and seizure symptoms again - they wanted to keep him overnight. I agreed to let him stay and drove to the clinic to visit the little patient. When I arrived, other than finding him a bit woozy, he was still the adorable little boy that I knew and seemed happy to see me. I stayed and hung out with him for awhile before heading out to meet friends for dinner. At this point it just seemed that the doctors were hoping that whatever had made him ill would eventually leave his system and he would return to his healthy self.

But the next morning I had another, more distressing call. Overnight Bosco had continued to show more facial seizure activity. The charcoal formula they'd given had long since passed through his system and any toxic response should have subsided, yet he was still showing symptoms that the doctors now believed were neurologic in nature, and not the result of poisoning. They said they could offer no other treatment and that I must transfer him to another clinic where he would need to see a neurologist. They referred me to VCA Animal Care Center of Sonoma County.

At VCA Dr. Melanie Campbell examined Bosco, who's' face was still twitching, looking as if he were nipping insects flying around his head. Along with the twitching came profuse drooling. Dr. Campbell said there were several possibilities - perhaps it was bacterial, like meningitis, or perhaps something more obscure, and suggested a blood test and an MRI to begin the search for possible causes. I agreed to the tests, knowing it would be costly but with Bosco showing such strange, troubling symptoms, feeling that I had no other option.

It was at about 3pm that I got a call from Dr. Campbell in which I heard her say that the MRI had shown  a "mass" in Bosco's brain. Stunned and speechless for a few seconds, she recommended that I "come in and go over the images" with her. From her utterance of the word "mass" forward, things seemed to become strangely slow and the world went eerily quiet as I walked out of the house and got into the car to drive the 20 minutes to the clinic.

I remember Dr. Campbell walking into the examining room and putting up the MRI imagery on the light box, pointing out the "mass" and area of swelling (edema) so large that it seemed to be pinching a main artery in the brain almost shut. I began to blink back tears and glanced into the her eyes, which I'm certain had begun to tear up as well. Though it is now difficult for me to remember the order of things from that day, I think she offered to bring Bosco into the examining room and came back holding him in her arms, handing him to me. There was that solid little guy with his gorgeous honey, caramel and black watercolor shaded spots and his big beautiful brown eyes. He wasn't drooling or twitching and seemed to have bounced back from the anesthesia they'd administered for his MRI session. Dr. Campbell continued, explaining that tumors were nearly impossible to diagnose with 100% certainty and that doing a spinal tap could be helpful to discern if something viral were occurring. I agreed to the spinal tap and another specialized blood test that would be done at UC Davis Veterinary School and would be the most comprehensive blood test for anything bacterial or viral in nature.

Because the spinal tap was yet to be done, Bosco was to stay the night and I would pick him up the following morning. Dr. Campbell strongly recommended immediately putting Bosco on a strong dose of Prednisone, a steroid, to reduce swelling in the brain and Phenobarbital as an anti-convulsant. I agreed.

The next morning I was anxious and excited to see Bosco but also tense because not only would I be picking up my now seriously ill dog but we were to fly to New York the following day. The doctors and I had some concern about how my little guy's head would feel with the pressure of the altitude changes but there was no postponing my flight as my job demanded I return to close several important real estate transactions -  income that would surely be needed for whatever treatment route Bosco and I might embark upon.

I was shown into a different examining room with a red love seat, a small desk and grayish mauve carpet. Bosco was lead in on a nylon leash. As I got down on the floor to be closer to him, he wandered around the room, sniffing everything and somewhat ignoring me. Then he stood still and began to pee on the carpet. I lunged toward him to try to get him to stop but he just looked at me helplessly and continued to make a large puddle. This was a sign of things to come.