In late February 2024, Pike was diagnosed with cancer.
For a few days, something felt “off” with Pike. Nothing crazy. Just “off”. But I had been sick for a week, and he had been spending most of his time just resting with me on the couch. So him not finishing his breakfast or dinner didn’t seem too concerning, and isn’t out of character for him either. He’s always just been a lazy eater. But then I noticed changes to his respiration, and discomfort when I would carry him up the stairs.
On Tuesday (2/20), just a few days after noticing these symptoms, Pike refused to eat from anything other than my hand. So I hand fed him, kibble by kibble, and he ate his entire meal. I thought, hoping, maybe he had just tweaked himself, and didn’t want to bend his head down to his bowl. So I gave him some pain medication, and we went to bed. The next day, he refused even being hand fed, and I knew something much worse was going on.
We ran to take X-rays, which revealed Pike’s entire chest was full of fluid. My heart sank. Nothing “good” comes out of a chest full of fluid. But we got to draining, and pulled what we could from his thoracic cavity. 380mL of fluid. We couldn’t distinguish anything obvious from his X-ray, so we scrambled to get him into a specialist for an echocardiogram. With some luck, there had been a cancellation for Friday morning. We started a diuretic in hopes it would aid in removing some of his effusion, and I monitored him closely until our specialist appointment.
Friday morning (2/23), Pike’s echocardiogram showed us a 31x40mm heart-based tumor. Comparable in size to a golf ball. This tumor, known as a Chemodectoma, is a rare form of cancer, affecting less than 1% of dogs, with brachycephalic breeds being more predisposed. These are usually slow growing tumors that are locally invasive with a low metastatic rate of ~10-20%. But Pike’s is causing pericardial effusion (fluid in the sac surrounding the heart), and secondary effusion into his thorax and abdomen. They were able to perform a pericardiocentesis right then to remove most of the fluid from his pericardial sac (130mL).
We were told within 24 hours, the remaining secondary fluid in his thorax and abdomen would resolve on its own. And within 48 hours, my sweet boy was acting completely normal. But this was just a temporary fix. The tumor will continue to cause effusion, and will continue to grow. We needed to speak to a veterinary oncologist to see what options we had.
Wednesday afternoon (2/28), we had our appointment with the oncologist. We were given three options for palliative treatment: radiation, surgery, or medication.
– Stereotactic Radiation Therapy would be delivered under anesthesia on 3 consecutive days. It has been shown to be safe and effective for controlling chemodectomas with a median survival time of 404 days. The most common radiation side effects reported are pneumonitis and less likely cardiac arrhythmias.
– Surgery to remove the tumor is not an option. With its location being at the base of his heart, the risk to remove it is too high. So the surgical option would be to partially remove the pericardial sac. This would allow the fluid the tumor is causing to flow into the thoracic cavity instead of the tight space of the pericardial sac (which puts pressure on the heart and can cause heart rhythm disturbances, fainting, and outflow obstructions to the heart or other problems). With no pericardial effusion, and a slow effusion into the thoracic space, the body should be able to reabsorb the fluid, and there would hopefully not be a need to drain the fluid again. The median survival time with this procedure is 740 days.
– The medication, Palladia, has been shown to provide clinical benefit in dogs with chemodectomas. Of those who had clinical signs, 90% experienced improvement. It’s generally well tolerated, with the most common side effect being GI upset (nausea, vomiting, diarrhea) which can occur in up to 30% of dogs. The reported survival time has ranged from 478-823 days.
Given all the information we’ve received, we decided to start Pike on Palladia. He’d receive 35mg three times weekly.
His first dose was given 3/6/2024. We have been running labs every 6-12 weeks to ensure his body is tolerating the medication, in addition to follow up X-rays every 3-6 months to check for cancer spread.
Pike hasn’t experienced any medication side effects these last 14 months. We’ve seen no effusion return, and even a follow-up echocardiogram in December showed his tumor has shrunk to 26x33mm.
I am beyond grateful for this medication, and the life it has given my souldog, Pike. Not only has it saved him, but the quality of life it has provided has been unbelievable. He’s eager to eat, excited for walks, and still just as playful as ever.
This time last year, I didn’t think he’d make it to his 11th birthday. Now, I’m confident he’ll see his 12th. And I’ll soak up every extra day we have together.
Any donations will go towards Pike’s Palladia, as well as the labs and X-rays needed to continue monitoring him while on this medication.
