When Alfred was accepted into the Canine Brain Cancer clinical trial at the University of Minnesota, his outlook was uncertain, and still is. The surgery was risky, but successful and he has been seizure free since then. In January before diagnosis he suffered four seizures in 12 hours, and was having at least one seizure a day up to that point. Surprisingly, aside from vision loss in his right eye, we have witnessed no other detrimental signs after his skull and brain were cut open. He’s bright, intelligent, has good long and short term memory, and his personality unchanged.
As mentioned in earlier posts, Alfred has been receiving a personalised immunotherapy vaccine and peptide treatment as part of a clinical trial. The big questions now surround this treatment and how effective it will be against a highly aggressive form of cancer. At some point this cancer will return, but the hope, and data from the trial so far, suggest tit will halt progression for a while, extending both his life, and quality of life – as it has already done.
There are some indicators to watch out for which give clues to how active the cancer. Seizures being the big one, but also watching for signs he has a headache, is sleeping too much, starts circling or begins to lose vision in his left eye. So far we have not witnessed these. So the only way to see what is going on inside his head is imaging. This will show in real time if the tumour has regrown, and by how much. The MRI had been scheduled for the 6th of July and I planned to return from London to be with Alfred and Renée when it happened.
Getting back to the States was touch and go, and much confusion surrounded who could and couldn’t travel. Fortunately for me, my brother was returning to California a few weeks before me and was turned back at Heathrow by Homeland Security. He was travelling on a visa and needed to wait for a letter from the US agreeing his visit was in the US national interest before he could fly (it took another week). This mess enabled him to give me a heads up on what to do to board my own flight as I was with him when it happened and could ask. I needed an ESTA waiver, copy of Renée’s passport, and a copy of our marriage certificate. I had all of these items. What I didn’t expect was the ESTA being cancelled on the morning of the flight. I suspect the airlines supply passenger lists to the US overnight after people have checked in online, and in turn the US cancel the ESTAs due to the pandemic. At 6:30am I applied for a new one and was lucky to see it come through to my email while in a taxi heading to the airport. I was flying. Hopefully.
I’d been away from Alfie (and Renée) for two months. What a welcome I was given when they pulled up outside Tyson McGhee airport in Knoxville. My four legged friend literally jumped through the window and into my arms when he realised I was standing at the car door. We both wore big smiles.
The drive to Minneapolis I’d been dreading. Renée and me are both seasoned road trippers but 1,000 miles in one 15 hour day is a bit much even for us. We left early at 5:30am and arrived by 9:30pm. Swapping over the driving seat each time we stopped helped. As did staying off the big Interstate roads as the scenery more interesting.
Arriving at the hotel was interesting. A few months had past since we were last here but Alfred knew where he was, and was excited to see the place, leading the way to which door was ours. Except we were on a different floor (same corner of the building and floorplan). Once inside you could see some confusion. I’m guessing he could smell his own scent everywhere else, but now somewhere that looks the same but smells different. The two of us had fun playing fetch with a ball in the corridor leading to the car park – something we enjoyed together here before his surgery.
A couple of days later we dropped off Alfred to Professors Liz Pluhar and Susan Arnold at 6am. He would be checked over, weighed, have blood work and then anaesthetised as you have no chance of a dog keeping still in an MRI machine. He was shaking a little before we handed him over, who knows what he remembers from before? Not much I suspect, but he’s not keen on being at the vet and knows exactly what sort of place we are in. There were a couple of other dogs waiting – they were also doing their best to either blend into the wall or pull for the exit.
Once he was handed over, we were told we could go, and wait for a call. When the call came it was Professor Arnold. It’s an anxious call to be waiting on; would be be OK? Is the tumour back? Even the anaesthetic a risk. We were worried. Quickly we were reassured Alfred was fine, and told she and Liz were delighted with his progress so far.
His MRI looked good. There is an area of uncertainty which may, or may not, be some regrowth. It is inconclusive for now. The images below show the tumour before surgery (on the left, large grey mass), the middle image is immediately after surgery (large grey mass gone), and the right image as he is now. The bright white area is fluid (the brain fills holes with this). Just above the fluid is the area of debate. Is this tumour? We don’t know. But overall, his team at the University of Minnesota are very happy, and that makes us happy. That the tumour has not yet returned is of no surprise for the team as generally this is the case at the 4 month marker. We will continue to watch him closely, but think we can relax a little, for now. We will next return here early October for another MRI. After the initial surgery, Liz said they would operate again if he remains healthy when the tumour returns, and Susan reiterated this after the MRI, as well as briefing us on what to look for. Of course, hope is it all looks similar to today come October. Time really will tell.
What his Professor Arnold was less happy about is his weight. Easy to spoil him given what he has been through, and there is no question he has been fed too much. Also, living with his nana and papa will no doubt be contributing. Renée told me her mom made him a chicken breakfast last week and she needed both hands to lift it! We have been told to reduce his intake by 25%, and we will. But for tonight a celebration is in order and we plan on eating at one of America’s finest establishments. Chick-fil-A here we come!