Canine Nasosinal Tumors: In Memorium To Declan
It was great sadness that we had to bid farewell to our glorious Declan at nine years eight months of age. I was so looking forward to having four ten-year-old wolfhounds in my home, but alas, it was not meant to be. It came as even more of a surprise as Declan had always been extremely healthy and she would have been the last wolfhound I would have expected to leave us.
Declan was euthanized due to advanced nasosinal cancer. This disease was a first for me in my nearly 35 years of immersion in this majestic breed. In the end, she was glad to go, but she fought like hell to survive in the weeks leading up to her passing.
I have always stressed to anyone who would and will listen that the Irish Wolfhound breed is too damn stoic. Far too stoic and, in my opinion, this stoicism jeopardizes their lives. In this particular case, though, there was not much else we could have done, and I did all that I could do. In other situations not involving terminal illnesses, the only way to combat this stoicism is increasing our vigilance for even the smallest change in behavior. In doing so, we may head off a quickly downward spiraling illness that could take the life of our beloved companion.
Declan's Nasosinal Cancer.
Well, with Declan I first noticed that she was favoring eating her chicken wings on the left side of her mouth. I thought it somewhat odd but decided just to watch her for a day or so as I checked her lower jaw but did not notice anything. Then this favoring advanced to her eating her wings much more slowly which was definitely out of the ordinary as she was a voracious eater. Within two days, Declan began to go down fast developing a fever of 103.9. I made an emergency appointment with our soft tissue veterinarian surgeon and was fully prepared to have her anesthetized for a thorough mouth exploration. However, when we arrived our veterinarian examined her lower mandible and molars (Declan was very stubborn about having her mouth opened wide, and now we understand why) and noted her gums were bleeding. His immediate thought was that she had inflammation of the gums due to an infection which most likely was the cause of her fever. As such, he prescribed Cephalexin which has always been an excellent antibiotic, and I have had excellent results using it.
While on the Cephalexin, she did not improve and was eating very poorly plus she now had blood seeping from her mouth. We returned to our veterinarian immediately in which this time she was anesthetized so we could ascertain the cause of the problem. Once on the table, my vet rushed back to inform me that Declan had a large hole in the hard palate of her mouth near the upper right molars, and moreover, the four rear molars were so loose that one could move them with a finger. I hurried to witness the damage myself and was utterly aghast. How could this wolfhound even attempt to eat with such an open wound in her mouth? How was it she was walking around for that matter? I was stunned at the sheer stoicism of this noble animal in front of me lying on a surgical table. Of course, the only thing to do at this point is to repair the hole, but we could not close it entirely due to the massive infection, and therefore, a small section was left open for it to drain. Also, the four upper molars were removed, and a biopsy was performed including margins around the dead tissue. While we waited for her to become conscious, my veterinarian and I discussed the possible causes of this hole.
We discussed cancer as a definite possibility, but because of the proximity of the hole right next to the upper molars, it appeared that it most likely was caused by a bone. More specifically, a beef neck bone as the shape of a beef neck bone could allow for impairment in this unusual location. It was odd that the hole was not in the center of the hard palate or nearer the front of the upper jaw. My veterinarian has seen both bone injuries in other patients as well as nasal carcinoma, and it was his opinion that this case appeared to align itself more towards damage from a bone.
At this time we should have performed Nasal Radiography, but we did not as my vet believed that the results would be obscure due to the complexity of the anatomy of the skull and nasofacial areas. These include the sinuses, mandible, cavities, dental arcades, and subsequent shadows, lines, and ossifications. Looking back, I should have insisted so that I could have saved Declan from further suffering. However, at this time, the information presented to me supported the notion that this was a recoverable illness and I have regularly gone to heroic efforts to give my Irish Wolfhounds every opportunity and a chance at life, even when diagnosed with a mostly terminal diagnosis, excluding amputation and radiation therapy.
We then initiated a more aggressive antibiotic protocol of Baytril and Clavamox for 14 days. Amazingly, Declan's appetite improved the same day of surgery and later that evening while home she had a very healthy dinner. But, that did not last. What followed were strange breathing and coughing noises that sounded to me as if she had aspiration pneumonia. Accompanying this were sneezing and mucus discharge from her right nasal cavity. Despite that Declan was scheduled to undergo anesthesia to close the small gap previously left open for drainage seven days after the initial surgery, we were concerned and brought her back four days later for a re-check. Our veterinarian saw healthy, pink tissue surrounding the small opening left open for drainage. This evaluation was both positive and uplifting, and we thought that if I could eliminate the harsh breathing or what I believed to be a respiratory infection, then she would recover fully. The biopsy came back indicating extreme inflammation but could not rule out carcinoma. Seven days after the first surgery, Declan was again anesthetized, and the remaining opening closed.
As we finished her second drug protocol, this harsh, noisy breathing did not dissipate. The green mucus was appearing out of both nasal cavities now, and her right eye was weeping. Parenthetically, during my research, I discovered that this harsh breathing is a common symptom of nasosinal cancer technically called stertorous breathing. Still believing that we were dealing with a massive nasal infection and aspiration pneumonia as both illnesses have very similar symptoms, I investigated other drug protocols. I immediately thought of utilizing Rocephin. However, it presented too many challenges for obtaining it. I came upon a new 2017 Journal of Veterinary Internal Medicine titled "Antimicrobial use Guidelines for Treatment of Respiratory Tract Disease in Dogs and Cats," in which the scientists recommended treating Pneumonia with or without sepsis with Ciprofloxacin and Clindamycin. We began a new antibiotic protocol, but despite the new drugs, the green mucus now contained blood.
Declan did not improve, and we once again returned to the veterinarian's office and performed digital radiography on her lungs and throat and discovered an area tucked up in the left lobe of her lung that was implicative of infection. There were no tumors present in her lungs, and her throat radiography did not reveal any abnormalities. I decided that no more oral antibiotics were going to be administered and we used, as a last-ditch effort, an injectable medicine "Convenia" that lasts for 14 days. It is an antimicrobial drug indicated for the treatment of infections caused by susceptible strains of Staphylococcus intermedius and Streptococcus canis. Our consulting veterinarian specialists concurred, however, my hope had faded at this point as we were able to pry open her mouth to find a small hole that had reappeared.
It was now clear that it was a neoplasm and Declan was suffering. Shortly after she was euthanized at home and immediately after my veterinarian and I opened her mouth wide to observe that the one small hole had developed into at least two to three large holes in the hard palate of her mandible. After her death, I made some promises to myself. Although conservative actions are appropriate in many cases while dealing with diagnoses in Irish Wolfhounds, I regret not being persistent on obtaining a nasal radiography that may have revealed the tumor whether it was in her frontal sinuses or nasal cavity. If I had done so, I would not have allowed this magnificent creature to endure on the antibiotics regiments.
In closing, I firmly believe Declan's cancer could or would have presented itself with even more severe symptoms such as facial abnormalities or significant distant spread (metastasizing) if it were not for the Systemic Enzyme protocol she and all my wolfhounds receive, on a daily basis. I have been a proponent of regular systemic enzyme consumption for combating inflammation, regardless if it were from arthritis, cancer, injury, panosteitis, skin & coat conditions, autoimmune diseases, and age. Systemic enzymes such as Vitacost.com Flavenzyme or Garden of Life Wobenzyme are two of the best brands available (See Below). Most importantly, these are given on an empty stomach at least 1 hour before food.
Consider even more benefits of systemic enzymes, as I quote Mary Straus of The Whole Dog Journal July 2012 Issue,
"Studies in the U.S. are limited, but systemic enzyme therapy has been studied and used in Germany for decades. For example, a 2008 German review (http://www.ncbi.nlm.nih.gov/pubmed/19116226) of “rigorous clinical studies” published in the journal Integrative Cancer Therapies found that “systemic enzyme therapy significantly decreased tumor-induced and therapy-induced side effects and complaints such as nausea, gastrointestinal complaints, fatigue, weight loss, and restlessness and obviously stabilized the quality of life. For plasmacytoma patients, complementary systemic enzyme therapy was shown to increase the response rates, the duration of remissions, and the overall survival times.”