Alfred is a Boston Terrier. Three and a bit years old. He’s a friendly little dog who’s spent his life living in London bringing joy to people he meets and the occasional bit of chaos. When we went to collect him as a seven week old puppy from Derbyshire, I remember laying out some ground rules; he would not be allowed on the sofas, would not be sleeping in our bed, and would not be coming to work with me. I’m sure there were other boundaries mentioned I’ve long forgotten. I now know rules with dogs rarely last long and it wasn’t long before nothing was enforced. Although Alfred was a gift for my wife, he is the text book example of a man’s dog and early on we became inseparable. In fact, the only time we have really been apart for more than a week was when we did the road trip this blog was originally about – and he very nearly came with us on that too. Dogs find a way into your heart from day one.
One evening, just weeks ago Alfred suffered a seizure. He was asleep (on the sofa) and started fitting and foaming at the mouth. It was horrifying to see, and we both thought we were going to lose him before our eyes. After about five minutes the episode stopped and he recovered, but it was clear something was very wrong. Conversations went back and forth with our vet in Blackheath, Dr Eleonora Corsi, who tried but was unable to get him an emergency referral for an MRI despite the seizures happening every few days. This is COVID-19 pandemic Britain and hard to access many things. Until things got really bad. Four happened in 12 hours. Eleonora pushed again and we were soon accepted at the Royal Veterinary College based at the Queen Mother Hospital in London for him to see their neurological team. We drove Alfred there and handed him over to Dr Sarah Butterfield. An overnight stay and some imaging confirmed our fears; a brain tumour. When Sarah called me to give me his diagnosis her tone told me what was coming before the words left her mouth.
Sadly the type of tumour Alfred had was large, likely an aggressive glioma, and in a place to difficult to operate on. His outlook was palliative care with perhaps two months of life. Until this point I had no idea how devastating news like this could be. Not just for his owners, but for everyone who knows him. Glioma’s are nasty tumour to have, for humans they account for about 30% of brain tumours and are usually cancerous. Dogs are also common sufferers of gliomas, and snub nosed breeds like Boston Terriers are higher risk than most.
After about a week, the initial shock faded and my own brain started to function once more, and the questioning of whether something could be done started. Google revealed much support for what the Queen Mother Hospital had told us, alongside with reading the tales of others on websites like Mumsnet where the realisation of what the path to the end looked like hit home. How on earth could I find the strength to euthanize this little creature who has shared so much with me as his suffering inevitably worsened. Emotionally it was hard now, but now nothing in comparison to what lay ahead.
I’m sure people who have been diagnosed with brain tumours, or any life-ending illness go through a similar process; shock. upset, anger, hopelessness. And I’m sure many look for alternative ways to give hope, be it through, alternative medicine, or clinical trials, or prayer. For Alfred it was the latter two. Perhaps one delivering the other.
The company I own, thinkerdoer, specialises in branding life science businesses, and as a result I’ve a good knowledge of how effective gene and cell based medicine can be, and the potential it holds. Treatments like these are just starting to become mainstream after years of promise, and a great many potential life-saving medicines are in clinical trials. Before these trials reach humans there is usually an animal pioneering the way; a mouse, a monkey or a dog. You might not like the idea, but faced with the prospect of losing a loved one not many of us would protest too loudly. And it was these trials involving animals I sought out. There were a few, all of the ones I found in the US, and I reached out to a couple who’s treatments I thought may be worth a try. In particular, there was one at the College of Veterinary Medicine of the University of Minnesota that stood out as they were using Boston Terriers for their canine brain tumor trials. I Emailed Dr Liz Pluhar who runs the programme and a little to my surprise she got back to me.
Dr Pluhar confirmed what the Queen Mother Hospital had said; a large tumour, very difficult to perform surgery on due to its position and the risk of operative bleeding. She also thought it may be either a choroid plexus or glioma so perhaps not suitable for her trial. We arranged a Zoom call and talked it through.
Having read plenty on what Dr Pluhar does, her 20 or more years of expertise and practice in her mission to find better treatment for brain cancer, watched presentations on YouTube that Renée discovered where she explained the study, and shared all of that knowledge with my business partner Lynda who’s day job involves understanding what scientific businesses do, Dr Pluhar was perhaps a little ambushed on the call. But she was confident and passionate about what she does and gave a much deeper and up-to-date insight to how here work is progressing. Whether-or-not Alfred’s tumour was a high-grade glioma (what her research requires) or a low grade, or a choroid plexus (which would not qualify for her clinical trial) she was willing to help us and confident she could perform the difficult surgery successfully with her team. We just had to get to her while Alfred had time left.
As mentioned earlier, dogs typically live two months from diagnosis to euthanasia. It would be of some comfort to think a big seizure simply takes them when the time comes but that isn’t the way it works; the seizures come more rapidly, last longer, the dogs end up in constant pain, often losing their sight, become incontinent, don’t want to eat. Just like this disease plays out in people. Everything I read from others who’d experienced a dog with a brain tumour ended in them eventually ending the dog’s suffering. It was something that had been playing on my mind as Alfred really dislikes going to the vet. To think of his final moments being there, shaking and frightened as I gave the order to end his life bought tears to my eyes. Still does. But Dr Pluhar had given us hope. Already a few weeks post diagnosis, the clock was ticking. We just had to get him to her.