petMD News readers first met Annie and her parents David Sage and Judy Helton in With a Little Help from Her Friends, Annie Sage Found Love and Health. We now have the opportunity to share an update on Annie’s condition, as written by her veterinary oncologist, Dr. Avenelle Turner.
Annie is still battling Transitional Cell Carcinoma (TCC), an aggressive bladder cancer that was diagnosed in November 2010. Unfortunately, Annie’s disease recurred and caused an obstruction in her urethra, making it difficult for her to urinate.
Considering it has been a year and a half since Annie’s initial diagnosis, recurrence and/or progression of this cancer at this time point is not unusual. On average, the prognosis (life expectancy) for dogs treated for TCC, with a combination of surgery and chemotherapy, is one year.
Annie’s recurrent tumor was small and there was no evidence of disease spreading outside of her bladder (metastasis). Since her TCC remained confined to the bladder, an interventional radiological procedure (bilateral ureteral and urethral stent placement) was recommended to address the tumor that was obstructing her urethra and partially obstructing her ureters (the small tubes connecting the kidneys to the bladder). This minimally invasive procedure uses a combination of surgery and fluoroscopy to place a rigid stent in the urethra and ureters, which opens the segment blocked by the tumor.
After her urethral/ureteral stent was placed, Annie underwent a short course of chemotherapy and radiation treatment. She made a full recovery and showed no overt symptoms of her disease.
In April 2012, Annie’s routine blood profile showed some abnormalities and she was exhibiting clinical signs of general discomfort. An ultrasound of her abdomen revealed kidneys changes consistent with an obstruction of the ureter. This potential complication of stent placement is typically resolved by stent replacement. Annie had an uneventful procedure and quickly recovered. She is currently asymptomatic for TCC, urinating comfortably, and back to her sassy self.
Annie’s battle with transitional cell carcinoma is quite unique (i.e., she has outlived expectations), and she is truly an example of the positive outcome of aggressive cancer treatment combining multiple modalities (chemotherapy, surgery, etc.). David Sage and Judy Helton (Annie’s caretakers) feel that their decision to pursue treatment despite the risks and the potential that additional procedures may not be successful was made in the interest of Annie’s best possible quality of life.
Advances in veterinary medicine permit the continued development of treatment options for cancer and other illnesses our canine and feline companions may face. Often, the same advanced procedures performed on humans can be applied to our pets. Unfortunately, there are no guarantees in medicine and the treatment approach used for Annie may not have been as successful in a different animal.
What Annie’s story teaches us is that there are many means available to treat cancer in our pets and that the results may be even better than those predicted by medical data. "I could have a new car with the amount of money spent on Annie’s medical bills," said Judy, "but I have no regrets and seeing Annie do well is more than worth it."
From top - Judith Helton, Annie, and David Sage
Dr. Patrick Mahaney
Image: Annie Sage