On Wednesday my husband and I took our Springer Spaniel, Merit, to Texas A&M Veterinarian Small Animal Clinic to see a Dermatologist. Merit was diagnosed with skin Lymphoma. The wonderful veterinarian was so touchingly kind, saying Dermatologist Vets rarely see death and it was sad to her to give her diagnosis to such a good dog and kind people.
We would like your prayers for healing for our 13 year old Spaniel. The diagnosis is terminal in just a few weeks to months. Merit is 13 and we are so fortunate to have had So Many Good Years with this stellar, good boy, Dog. The Vet agreed that at Merit's age - he could still have something like a cataclysmic event (like heart attack) and go to God's heaven for loved and loving animals of His creation.
Of course 13 is like 90 people years, so your prayers are for peaceful passing for this wonderful, wonderful dog. We've met with our Church Couples Group for 11 years now. Merit is known as the dog who would stand on his hind legs to put his front paws into the holding hands praying group. He is just that kind of dog.
I am hopeful. And today thinking of Elijah being picked up in a chariot to go to Heaven pulled by horses sent by God. Someday I hope to be with Merit and see Elijah's horses. And when I get to one of the 12 gates of Heaven, each with a Pearl Gate, I want to see a very particular dog with his beautiful gated run. Betcha I will.
Thanks for your prayers. Much appreciated.
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11/26 Merit continues to be the bouncy, happy dog he has always been. Still cartwheeling around when the leash is in sight. Loves to walk. For the last two days - he has not needed his medication. Really great quality of life unless a bread product is eaten. Edward & I feel like he is prayed for and doing well. Sometimes he is tired or less than mobile than before. I continue to pray for him each time he is medicated, fed or just needs some loving. So, Lord, Father God - thank You. Amen.
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1/12/12 We are continuing to thank Father God. Merit has been healed. We were told his wounds would turn in to tumors. They did. We were told he would and could take up to 6 steroid tablets a day. He did. We were asked how many of these tablets we would purchase and I suggested 100. Our wonderful and caring Vet looked doubtful. I asked how long. And she replied between 3 weeks and several months. The Vet said no healing would occur because this is cancer. The tumors are gone and Merit continues to be healthy and happy. It has been several months now since he required any steroid tablet. His tumors are gone. He does not have an open wound on him any where.
Thank You, Father God. Thank You, for the people who prayed for Merit. In Jesus' name. Amen.
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May 7th, 2012
A Continued Thank You, Father God! Thank You, for the people who prayed for Merit. In Jesus' name. Amen.
About a month ago Merit had an abscess in his front canine causing his muzzle to swell up very considerably. He went to a new, local Vet and that Vet was rather incredulous that Merit is 13.5 years old. He asked me if I was sure. Yes, Merit was born in September of 1998. He healed very well with one round of antibiotics and has his teeth scrubbed with a wash cloth with canine toothpaste. He is doing marvelously well and runs and jumps like a dog at least 10 years younger. God has blessed me with a very wonderful dog. And I thank HIM!
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Veterinary Medical Teaching Hospital
Texas A&M University
(979) 845-2351
www.cvm.tamu.edu
Dermatology Discharge Summary
Owner:
Anne Gardere
Patient: #201135, Merit
DOB: 00/00/98
Weight: 42.55 lb, 19.3 kg
Referring Veterinarian:
Angels Pet Hospital
24734 Kuykendahl Rd.
Tomball, TX 77375
Phone: 281-290-0360
Fax: 281-255-3829
Admission Date: August 2011
Discharge Date: October 19, 2011
Recheck Date- As needed
Clinician: Alison D DVM
Student: Cami W, 4VM
Thank you for entrusting us with Merit's veterinary care. Please read this letter carefully. Parts of this letter are written for your own understanding with other areas reserved for your primary care veterinarian.
Merit, a Castrated Male, Black/white, English Springer Spaniel Canine was admitted to the Texas A&M University Veterinary Medical Teaching Hospital on October 19, 2011 .
Reason for Visit / Problems - Steroid-responsive pruritus and scaling of 2 months duration
History - Merit is an indoor dog that receives monthly Heartgard and Frontline. He has not had skin issues his entire life until the age of 11 when he had two hot spots that healed spontaneously. In August of 2011 on a drive to Dallas, Merit excoriated and lacerated his axillary and chest area. He was taken to his primary care veterinarian who prescribed prednisone and 500mg of Cephalexin. Merit only got one dose of prednisone but finished his 2 week course of antibiotics. His pruritus completely stopped within 24 hours of taking the medication and for 1 week after they were finished. The lesions healed some but not completely. One week after finishing the antibiotics, the pruritus and self mutilation returned. Merit was put on another 2 week course Cephalexin with no steroids. This time the pruritus remained. Merit has been on Science Diet all his life but was recently switched to gluten free Taste of the Wild Salmon and Lamb. He is current on his vaccinations and his only surgeries to date were his neuter and sebaceous cyst removal. He lives with 1 healthy cat.
Physical Examination - T= 101.6F, P= 160bpm, RR= pant, CRT<2s, MM=pink/moist
On physical examination Merit was bright, alert, and responsive. His heart sounds were strong and regular with no murmurs ausculted. His lungs were clear bilaterally. He had moderate dental calculus on both arcades.
Dermatological Examination -
Merit's skin had generalized marked exfoliative scaling, especially apparent over the dorsum and shoulder area. He had a large crust with matted hair behind his left ear, and a small scab behind his right ear. He had multifocal large erythematous plaques with crusts and severe exfoliative dermatitis located over his chest, lateral limbs, axillary regions, and ventrum. His perineal area was inflamed and matted with a large crust located ventrally. The rest of the mucous membranes however did not appear to be affected. There were several areas of depigmentation on the paw pads (all four feet, multiple pads affected); uncertain whether normal for the dog or depigmentation change in skin.
Diagnostic Tests & Procedures -
Skin scrapings- Negative for demodex mites
Skin impression cytology- Skin cytology revealed abundant, round lymphocytes, mostly uniform in appearance with a moderately abundant cytoplasm. His rectal area showed numerous cocci and neutrophilic streaming.
Skin biopsy- Declined at this time
CBC-
Test Result Reference Unit
WBC 5.8 6.0 - 17.0 ul
Red Blood Cell Count 6.08 5.50 - 8.50 M/ul
Hemoglobin 14.6 10.0 - 20.0 g/dl
Packed Cell Volume 41.7 31.0 - 56.0 %
Mean Corpuscular Volume 68.5 60.0 - 77.0 fl.
Mean Corpuscular Hemoglobin Concentration 34.9 32.0 - 36.0 g/dl
Plasma Protein 8.0 6 - 8 TS-g/dl
Platelet Count (Automated) clumped 200000 - 500000 /ul
Segmented Neutrophils 69 60 - 77 %
Absolute Neutrophil 4002 3000 - 11500
Lymphocytes 16 12 - 30 %
Absolute Lymphocyte 928 1000 - 4800
Monocytes 11 3 - 10 %
Absolute Monocyte 638 150 - 1250
Eosinophil 4 2 - 10 %
Absolute Eosinophil 232 100 - 1250
Test Interpretation: Within normal limits
Panel Interpretation Result
RBC Morphology Poikilocytosis 1+
RBC Morphology Rouleaux slight
RBC Morphology Anisocytosis slight
Platelets Estimated Count appear adeq
Platelets Platelet Morphology clumped
Neutrophil Morphology Normal X
Neutrophil Morphology Reactive Lymphocytes few
Sample Notations - Integrity of Sample Hemolysis 2+
Sample Notations - Integrity of Sample Disclaimer: Sample <1/2 full, excess EDTA can result in decreased MCV and increased MCHC.
Chemistry-
Test Result Reference Unit
Glucose 84. 60 - 135 mg/dl
Lactic Acid 32.3 9.9 - 46.8 mg/dl
Cholesterol 450. 120 - 247 mg/dl
Blood Urea Nitrogen 27. 5 - 29 mg/dl
Creatinine 1.04 .3 - 2 mg/dl
Magnesium 1.9 1.7 - 2.1 mg/dl
Calcium 11.0 9.3 - 11.8 mg/dl
Phosphorus 5.9 2.9 - 6.2 mg/dl
Total Protein 7.6 5.7 - 7.8 g/dl
Albumin 3.2 2.4 - 3.6 g/dl
Globulin 4.4 1.7 - 3.8 g/dl
Alanine Aminotransferase 43. 10 - 130 U/L
Alkaline Phosphatase 378. 24 - 147 U/L
Gamma Glutamyltransferase 26. 0 - 25 U/L
Total Bilirubin .4 0 - .8 mg/dl
Sodium 147. 139 - 147 mmol/L
Potassium 4.8 3.3 - 4.6 mmol/L
Chloride 116. 107 - 116 mmol/L
Enzymatic Carbon Dioxide 19. 21 - 28 mmol/L
Anion Gap (Calculated) 17. 10 - 18 mmol/L
Test Interpretation: Within normal limits
Panel Interpretation Result
Special Notes and Comments Lipemia 2+
Diagnosis/Differential Diagnoses - Cutaneous lymphoma (highly suspicious based on finding of large lymphocytes on cytology)
Therapy -
Medication
Generic (trade) Class or
Indication Administration Directions
Trimeprazine Tartrate And Prednisolone, Tablet Antihistamine and steroid Give 1 tablet by mouth every 12 hours as needed. You can alter this dosage as you see fit to keep Merit comfortable, with a limit of 6 total/day.
Radiation and chemotherapy- Discussed treatment options for cutaneous lymphoma with owners; declined at this time
Call if you note - Merit becomes uncomfortable (too itchy, painful, stops eating, extremely lethargic) or has an acute worsening of signs that worries you.
Client Instructions -
Cutaneous (epitheliotrophic) lymphoma is an aggressive form of cancer that arises from cells known as lymphocytes. It can, but does not usually affect the internal organs. Cutaneous lymphoma is usually diagnosed by biopsy, however Merit's skin cytology was extremely convincing for a diagnosis of cutaneous lymphoma; the cells noted were neoplastic in appearance just from the impression alone.
Unfortunately, the prognosis for dogs with cutaneous lymphoma is poor, even with treatment. Radiation therapy and chemotherapy with CCNU are available therapies, and generally only extend the lifespan by a few months. It's hard to say exactly what Merit's life will be like in the next few months. Our hope however is that the Temaril-P will provide some degree of comfort for him. You can vary the amount you give him as his symptoms change to keep him comfortable, giving him up to 6 tablets daily if necessary. You know Merit better than anyone, and he will let you know when it is time to say goodbye.
We are terribly sorry to be the bearer of such bad news and wish we could have given Merit something easy like a skin infection. He is a very sweet dog and we know that he has been an important part of your lives for a very long time. Take comfort in knowing that you have given Merit a long and fulfilling life. He is an "old man" in dogs years and has been extremely healthy up until this point. We are available to talk to you if you have any questions in the upcoming months, so please don't hesitate to call.
__________________________________ __________________________________
Alison D, DVM Cami W, DVM
Diplomate, American College of Veterinary Dermatology Senior Veterinary Medicine Student
Prescription refills are normally to be filled by the veterinarian who is reassessing your pet’s medical condition. Please contact your primary local veterinarian for prescription refills if he or she is performing follow-up care/rechecks of your pet’s dermatological condition. Routinely allow 1-3 business days for prescription refills submitted through the TAMU-VMTH pharmacy (979-845-9118). The Dermatology Department is not open after business hours, on weekends, or on holidays. Emergency care is available 24/7 through the TAMU-VMTH Emergency Service (979-845-2351).
Please see note in the middle of the page dated 1/12/12
11/21/12
Merit, our Springer Spaniel, celebrated his 14th Birthday September 23, 2012. His intake of Prednisone increased from occasional to 5 or 6 tablets a day in November. On November 21st, we noticed Merit was having trouble standing and sitting down. We took him to the veterinarian who said his life was not comfortable and he was not having quality of life, my husband, the veterinarian and I decided the humane thing would be euthanasia. We stayed with Merit and as the sun was going to set, Merit went home to be with his Maker.
The day before Thanksgiving was Merit's last day in our home and that seems very appropriate for a dog who gave such love and service making sure I was never in a room alone. Thank You, Father God for an exemplary dog living such a great life of love. Some the things I will always be grateful for in Merit, as a puppy he never cried for his litter, he never attempted to run away and if left too long in the back yard he would sit by the front door window. The day we bought our second home, he pirouetted through the larger rooms with me. The day the burglar just opened the front door one morning, before I had changed out of pajamas and Merit stood on both hind legs and growled like a bear making the man flee. And the day we discovered the fake snake in the pool, I jumped over the patio furniture carrying 41 pound Merit. I promised him when he was 3 months old he would gradually enjoy our long walks and I was fortunate he was still doing cartwheels over our walk just 3 days ago.
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