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labadore

Toby, My 7Yr Old Lab Has Histiocytic Disease (Histiocytosis)

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labadore   

Some poor dogs have more than their fair share of bad luck in life and unfortunately Toby, my 7yr old Lab rescue boy who I adopted 18months ago, is one of these unfortunate souls :cry:

Just as he had recovered extremely well from TPLO surgery at end of January this year for a ruptured cruciate ligament and torn meniscus and had returned to full function, he was then dealt a severe blow with being diagnosed with Histiocytic Disease which the Specialist Oncologist (Veronica) at the Small Animal Hospital (SASH) here in Sydney suspected was Systemic Histiocytosis with the Histiocytosis infiltrating the gastrointestinal tract (abdominal area) :cry: I had never heard of this insidious disease prior to Toby's diagnosis as it is quite an uncommon disease and there are different varieties of it ranging from benign to malignant.

The back story to all this is that when I adopted Toby he came to me with allergies and medication to alleviate skin itchiness and after chopping and changing his diet and having some success with much reduced itchiness and being off the medication, I got a referral from my Vet for an appt with Linda Vogelnest, the Specialist Dermatologist at SASH as I was concerned with his ongoing chronic ear infections and his allergies in general. Over the course of a few months of being treated by Linda, his chronic ear infections cleared up completely and he was hardly scratching at all and thing were going well for him on the allergy front.

In June this year, he developed a progressively worsening itch and given his allergy history, I thought he may need to have his diet tweaked again which I did for a few weeks, but the itching didn't resolve itself and his chronic ear infections started again, so I took him to my Vet. He was given a Cortisone injection to give him immediate relief from the itching and Prednisolone tablets to take for the next 4 days and thereafter every 2nd or 3rd day depending on the itchiness. He got immediate relief from the injection and the 4 days of Prednisolone, but when I reduced to every 2nd day he started getting itchy again but not as bad as before so I persevered for just over a week of every 2nd day and then reduced to every 3rd day for another week and the itchiness returned to what it had been prior to the Cortisone injection and his skin was beginning to flake quite badly. Also his poo was changing to a yellow soft serve consistency and a lot of it so I stopped giving him the Prednisolone tablets & put him on steamed rice and boiled chicken but this didn't help and his energy levels had changed and he was seemingly depressed. He was also developing some lesions around his eye and on side of his muzzle and losing hair on his neck.

I then made an appointment with Linda, the Dermatologist at SASH who treated his allergies and chronic ear infection last year and she was concerned with his deteriorating condition after checking him over and wanted to do bloodtests as well as cytology on the gunk in his ears & whilst getting this organised, she popped in to have a chat with the Oncologist (Veronica) about Toby and asked her to check him over.

He was then booked in for a skin biopsy the next day as they wanted to check for a couple of different conditions, the first one being Epitheliotropic Lymphoma and the test results a few days later came back negative for this condition. More tests (stains) were then done on the skin biopsied and a few days later the test results came back positive for Histiocytic Disease. :( A couple of days later he had an appt with one of the Medicine Specialists at SASH and same day an Oncology appointment with Veronica where Thoracic Xrays and Abdominal Ultrasound were done to check if the Histiocytosis was systemic (i.e. infiltrated any major organs like lungs, spleen, liver etc) and I had a discussion with Veronica on the diagnosis and treatment options.

Whilst all his blood tests were fine and there wasn't any evidence in the Xrays and Ultrasound that the Histiocytosis was systemic, the Oncologist believed it had infiltrated his gastrointestinal tract (abdominal area) causing the large yellow soft serve poo he has been having since July. The infiltration of the gastrointestinal tract/abdominal area cannot be detected by an ultrasound, an endoscopic examination would need to be done for that, but we didn't go down that route as not only did I not want to put him thru any more tests, I trusted Veronica's diagnosis that there was infiltration in his gastrointestinal tract (abdominal area). Also Linda (Dermatologist) has put him on two lots of antibiotics during our first visit, one lot to help with bacterial infection and the other to help settle stomach issues and despite the antibiotics and continuing with feeding him steamed rice and boiled chicken, the yellow soft serve/diarrhoea poo continued and that really provided the proof that the Histiocytosis had infiltrated his gastrointestinal tract (abdominal area). Also in amongst being treated by the Dermatologist and Oncologist, he also underwent more tests by the Medicine Vets to rule out other issues like Addison's Disease out of the equation.

From the outset, Veronica explained that this disease is frustrating and can be tricky to treat and if he had the systemic version the prognosis is not good :( . The only treatment option for him was to start him on Chemo and see what his response to the 1st Chemo treatment would be and then to do followup testing 2-3 weeks later and determine if Chemo should continue. Unfortunately for my gorgeous boy, the Chemo is not working and his condition has been deteriorating and I was concerned he would not make his next Oncology appt next week, so had a telecon with Veronica last night and based on his deteriorating condition I described to her she confirmed my worst fears that the disease has progressed beyond any further treatment. :cry: He is now on Tramadol to make him more comfortable while I grapple with that awful decision that has to be made to end his life and not prolong his suffering. :cry: I am organising a home visit by my Vet which I have done for my other past dogs. :cry:

To say I am devastated is an understatement :cry: This beautiful boy has been thru so much in his short life, from being abandoned by his original owners, shunted from home to home when his original owners tried unsuccessfully to rehome him themselves a few times before he was surrendered to one of the Lab rescue groups and when he finally found his forever home with me, he is dealt this most awful life threatening blow. :cry: I am very emotionally invested in this beautiful boy and whilst I have only had him for 18months, I have bonded very deeply with him and love him dearly and he is just such a sweetheart. I have worked so much with him on both behavioural (leash reactivenes & anxiety) and health issues to improve his quality of life and was so hoping for a long life for this darling boy. :cry: In the past my rescue Labs I have adopted have been seniors around 10 yrs of age who have been extremely fortunate in living long lives to 15 plus years of age and I was so hoping this trend would continue with this boy who I adopted at 6 years of age to give my other Lab boy, who turned 6 yrs old a couple of days ago, a mate closer in age to him as he had already gone thru losing his two best bates being the senior adopted boys who I had when I got him as a pup and who helped me raise him/mentor him. Now he will go thru losing another mate who he gets on extremely well with and has done since day 1 of Toby coming to live with us. :cry:

This is one of my favourite pics of Toby with his beloved ball.

IMG_20140511_151411_zpsf8if1tqp.jpg

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LisaCC   

I don't know what else to say except I am so so sorry Labadore.

You've done everything you can for Toby, he's such a darling looking boy. Some dogs are too good for this world.

Stay strong kissbetter.gif

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Dave73   

Im so sorry to read this. Poor boy! One thing you can be sure of is Veronika would of left no stone unturned to try and help Toby, she is the best of the best

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Tassie   

How very sad for you and Toby .. what a lovely boy he looks. You're right .. some dogs, like some people, just seem to draw the short straw. What a great owner you are to have gone the extra mile (and many more) for the lad ... and how precious are those 18 months of love and care you have given him. Can only wish you strength with the decision you have to make, and gratitude on behalf of the dogs for the love and care you have given this lad. :grouphug::(

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I'm so sorry for you and Toby - but regardless of how long he has, he is so lucky to have you to give him a last wonderful 18 months which is what he remembers I'm sure - and this final precious gift. Thoughts and prayers with you both.

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swazzie   

I'm so sorry to hear this Labadore. You have given him a wonderful 18 mth since you rescued him and I can only imagine how happy he'd have been with his doggie friends and you.

It's hard and so unfair but spend the time hugging and taking pictures if you can.

Big hugs to you xx

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labadore   

The day after I posted this thread and had contacted my Vet about putting my boy to sleep in a couple of days, my boy started showing some signs of improvement and over the next couple of days, continued to go from strength to strength with an almost miraculous improvement as he finally started responding positively to the chemo treatment. He continued to do well until around the last week in November when there were subtle signs that he was succumbing to the disease and this was confirmed in his last Oncology consult on the Wed 25th Nov.

My beloved boy lost his battle with this insidious disease and was PTS at home on Fri 27th Nov 2015. :cry: I had hoped he would have a few more quality days after his Oncology consult on the Wed and had made an appt for a PTS home visit with my Vet for Mon 30th Nov, but on Thurs late afternoon he started going downhill quickly and I slept in the family room for the night by his crate as he spent all night in there which was highly unusual for him and I couldn't get him to eat any of his favourite foods or even take some Nutrigel paste that day or night and next morning and was extremely concerned with his rapid deterioration and there was no way I was going to make him wait until Monday. I rang my Vet first thing on Fri morning and asked if she could come around that morning to put him to sleep and I am very grateful they were able to come around within 20 minutes of my phone call as they are just up the road from me.

His passing was very peaceful and in one of his favourite spots in the house, my bedroom on his bed where he had taken himself for a snooze in the morning after not wanting to come out of the crate all night. I was very happy that he chose to take himself to my bedroom for a snooze the next morning which took away the stress of having to get him to come out of the crate. I held him and cuddled him as he went on his journey to the Bridge :rainbowbridge:

I am devastated and heartbroken he got cut down in his prime, one month shy of his 8th birthday and never got the chance to live the long life he so deserved :cry: I miss him being my shadow, I miss our nightly cuddles on the couch, I miss him getting under foot in the kitchen, I miss everything about this beautiful boy. :cry: He was a very loving and extremely affectionate boy who I was very bonded with and he was extremely devoted to me. Despite his health issues, I feel very blessed he came into my life, albeit, for far too shorter a time, but his impact has been huge and I have cried a river of tears since losing him and will be grieving him for a long time to come. :cry: My other Lab boy has been very quiet and sad since Toby's passing, so I know he is grieving for him as well and I have been taking him on outings twice a day to try and help lift both our broken spirits. :cry:

Run free sweetheart with my other Labbies at :rainbowbridge:, you are deeply loved, very much missed and will never be forgotten. Toby (registered name: Aralyen Jingle Bell Rock) 25/12/2007 - 27/11/2015

This is how I like to remember Toby, a true Retriever at his happiest with a ball or toy in his mouth.

Toby_zpsrzqpjxuj.jpg

Toby%20with%20Toy_zpsnmrveoik.jpg

Toby%20with%20red%20ball_zpsifakp4qh.jpg

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harley   

So sorry for Toby's early departure. Sounds like he was peaceful. Many hugs for you xxxxx

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Tassie   
:cry: So sorry your lovely boy lost his battle. What a lucky dog he was though in having found you when he needed you, and having a lovely life for the last part of his life .. all too short though it was. And a blessing that he, with your help, was able to choose the time and place. All dogs should be showered with love like Toby. :rainbowbridge:

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labadore   

Thanks guys and yes Tassie you are so right, he did choose the time and place :cry: , he was going when he decided he needed to and I am very grateful to him that he made that perfectly clear, despite the prior arrangement.

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I am so sorry to hear this story. You did everything you could and Veronica Langova is an excellent oncologist.

Not much has been done on Hystiocytosis but the world experts are at UC Davis. Dr Peter Moore is Australian I believe.

My own dog was diagnosed with localised histiocytic sarcoma and survived 4.5 years and died cancer free from an accident. Had he had disseminated histiocytic sarcoma that would have been a completely different scenario. Lets hope more is done with this cancer so the future is brighter with dogs who have this diagnosis.

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