Vet column: How far will you go to help your pet?

You may wonder why someone should call us from so far away. Several years ago, Mrs Barbara McMillan lived in Prestonpans and was a regular client of Dunedin Vets. I have very fond memories of this lady and her lovely Bichon Frise dogs.

Several years ago, she called me late one night (yes, this was in the times when vets did on call). One of her dogs had given birth a few days previously and she was now panting and shaking.

I visited the house and examined the proud mum, who was obviously very unwell. I diagnosed she was suffering from eclampsia.

In dogs, this is a condition where the body calcium level drops dangerously low due to producing so much milk for the pups.

I rushed the bitch to the surgery, where I administered intravenous calcium and very quickly she was more like her usual self.

Farm vets are much more used to seeing this in cattle, where the signs are very similar.

Sometime after this, Mrs McMillan decided to change career and lifestyle, moving to the idyllic Isle of Lewis, where she set up a dog boarding kennels.

She was living her dream of being surrounded by dogs in a beautiful, tranquil environment.

I had occasionally thought about her, whilst relating my story of saving the bitch with eclampsia to other vets.

Last year, however, we had a call from Mrs McMillan, who was on holiday in the Borders, where she has a holiday home.

One of her dogs was unwell, so we liaised with her vet in Lewis and arranged treatment for the poorly pet.

We decided that she should remain registered with Dunedin Vets as well as her Lewis vet, as she was often at her holiday home. This comes back to why she called us a few months ago.

Poor Murdo had been unwell. He had a raised temperature and was generally out of sorts. Her vet in Lewis had been very concerned as he discovered that several of Murdo’s lymph nodes (glands) were swollen.

Now these are findings which could occur in many conditions, including severe generalised infections, inflammatory diseases and something which is unfortunately always in our minds: cancer.

Murdo’s vet decided that he required tests to be carried out to determine what the problem was.

Blood samples were taken to check his internal organs and for haematology (checking his blood cells), and to do a specific test for a type of cancer. Small biopsies were taken from his lymph nodes which were then sent to a laboratory for histological examination. This is to find out what type of cells are present in the sample.

When the vet received the blood results, Murdo was found to have a lot of white cells in his blood and many of these were abnormal.

The biopsy results indicated that Murdo did indeed have a form of cancer called lymphoma. This is a cancer of the lymph glands, causing them to enlarge and for abnormal white cells to spill into the bloodstream.

Murdo’s vet in Lewis had a serious discussion with Mrs McMillan. This is one of the cancers we can treat in veterinary practice.

However, the vets in Lewis are not set up to do chemotherapy and they recommended that if Mrs McMillan wanted to proceed with treatment, that Murdo should be referred to the vet school in Glasgow. This is when Mrs McMillan called us to see if we could do Murdo’s chemotherapy treatment.

At Dunedin Vets, we can do this. Thankfully we do not have many pets requiring chemotherapy, maybe one or two a year.

My colleague Chris discussed the treatment regime very thoroughly with Mrs McMillan.

She was, of course, very concerned about the effects the treatment would have on Murdo. Chris reassured her that, unlike humans, hair loss is not a common occurrence. Vomiting and nausea after the medication does occur and, yes, Murdo may feel tired after his chemotherapy but we can rest at ease in knowing dogs will not have an adverse psychological response to treatment.

Chemotherapy for canine patients comes with a cost and Murdo was not insured.

The main concern was the logistics of carrying out the treatment.

Murdo would require weekly intravenous injections and blood tests, plus oral medication.

Mrs McMillan said she would do anything for Murdo and was willing to embark on weekly trips from Lewis to her holiday home and to Dunedin Vets in Tranent for treatment. So this is how Mrs McMillan embarked on a 350-mile car journey including a two-and-a-half-hour ferry journey each way.

Chris also informed Mrs McMillan that Murdo would be excreting some of the chemotherapy drug from his body in urine and faeces, so the family would have to be very careful wearing gloves when bagging solids.

I also informed them that young children should not be handling Murdo, nor should any person who is immunocompromised.

This is exactly the same as is advised with a human patient undergoing chemotherapy.

We liaised with the vets in Lewis and they were very happy that we were able to perform the chemotherapy in a place Murdo knew.

Now we have to have a very special protocol for administering chemotherapy to pets.

Myself and nurse Nicole have to wear special gowns, gloves, masks and goggles. The drug has to be given intravenously once a week.

Murdo comes to our Tranent surgery, where he has a blood sample to check his blood cell count prior to administering the drug, to ensure his body is able to cope with it.

We also like to check a urine sample, but Murdo is not always obliging!

Now if Murdo’s white cell count falls below a certain level, we have to postpone his treatment until it rises again.

If his white cell count is too low, then Murdo will be unable to fight infections and this can make him very ill.

One of the infections he may develop is a form of cystitis which would cause him to pass blood in his urine.

He has a catheter placed in his front leg vein. The drug has to be drawn up into a special applicator so that it never comes in contact with any member of staff. All the equipment used each time has to be placed in a special bin for incineration.

At home, Mrs McMillan has to give Murdo other chemotherapy tablets daily, ensuring she wears gloves and keeps the drugs away from humans. She also has to give another tablet to stop him feeling nauseous.

After the first week of chemotherapy, Murdo’s enlarged lymph nodes had returned to their normal sizes. Mrs McMillan reported that Murdo was back to his old self, keeping the other dogs in their places.

Murdo has had his first eight weekly doses of chemo, so he’s travelled quite a number of miles. He is now on fortnightly injections, which he will continue on until November.

Murdo is a very happy dog. He sits patiently on the consulting table whilst having his bloods taken and his chemo administered, but as soon as he is on the floor he barks for attention.

Murdo’s lymph nodes continue to remain small and we are very pleased with his treatment, as is Mrs McMillan.

Murdo has never been nauseous and loves his food; in fact, he has put on quite a bit of weight since starting treatment, contrary to what you might think of a patient with cancer undergoing treatment.

Generally with this form of lymphoma cancer, we have to monitor the patient for life. After six months, we should be able to reduce the treatment regime.

Only time will tell how Murdo will be in the future, but at the moment, this far-travelled wee dog is enjoying life to the full and his owner is so pleased with his progress, despite the huge effort she is making to ensure he gets his treatment.