I came across this poem...it couldn't be more true.

(Author Unknown)

You can't buy loyalty they say:
I bought it though the other day.

You can't buy friendship, tried and true;
Well, just the same, I bought that, too.

I made my bid, and on the spot,
Bought love and faith, and a whole job lot

Of happiness. So, all in all,
The purchase price was pretty small,

I bought a simple trusting heart
That gave devotion from the start.

If you think these things are not for sale -
Buy a brown-eyed pup with a wagging tail!

Today Newton had a physical examination and some blood work done.

The results from the bone biopsies came back inconclusive. A histologic examination of the amputated leg will tell us what type of cancer it is. This will aide us in determining which Chemotherapy treatment option will be pursued.

I must say that I am very proud of Newton. At each visit, Newton is the rock star of the hospital. He did not bark at a single dog, man, woman, or child. He has been on his best behavior. I would like to say it is a result of his neuter ;-) although I'm guessing his limp plays a little bit of a role there too. Everybody wanted to meet him and he was wagging his tail the entire time. I think he enjoys the attention.

Newton is back to his spunky self post-biopsy. With the exception of the limp, which seems to get less each day, bone cancer is not effectly his lively spirit.

Today Newton had an appointment up at CSU. He had the following done:

• Physical Examination and some blood work
• Tumor Measurement - Dr. Perry indicated that the tumor hadn't grown in size since the last set of X-Rays taken on September 3rd. He also mentioned that the team thought they saw something on an X-Ray of his right leg, so they took some additional X-Rays to make sure that it wasn't an area of concern as well.
• Gene Therapy Administration - They also injected the tumor with a gene therapy that has demonstrated anti-tumor responses in rodents and in canine oral melanoma. As I understand it, the gene is carried to the tumor cells by an adenovirus vector with the intent to induce apoptosis (programmed cell death).

During his appointment, they also did a Jamshidi bone biopsy under fluoroscopic guidance. Dr. Perry indicated that the collected specimen may only contain reactive bone. Due to the specimen consistency (if that makes sense), they collected multiple biopsy specimens to improve the changes of making a diagnosis.

Newton was in quite a bit of pain coming home. Mary let me borrow her mini-van. THANK YOU MARY! The mini-van was a life savor. He is on 2.5 chewable tablets of Deracoxib (100 MG) a day and 3 tablets of Tramadol (50 MG) twice a day.

Throughout the weekend, I spent a lot of time researching canine bone cancer and the various treatment options. This weekend made me appreciate the value the Internet provides. Ten years ago, information would have be a lot less assessable. I found a ton of awesome sites and Yahoo! groups. You can find the links on Newton's "Links" page.

We caught Newton's cancer very early. According to Dr. Ehrhart, it is a Stage II. Stage II means that the cancer has not spread, but can be seen coming through the bone cortex. Based on the X-Rays, that he is giant breed, and the location of the tumor, it sounds like it is most likely Osteosarcoma. Although unlikely, I am told that there is a possibility of other kinds of bone cancer (Fibrosarcoma, Hemangiosarcoma, etc.). Dr. Ehrhart said treatment is very similar for the other tumor types. Armed with this information, I decided that we would pursue the "gold standard" of treatment: Amputation followed by Chemotherapy.

After much discussion, Mary and I decided that the "Gene Therapy for Canine Osteosarcoma" clinical trial would be the one that I would pursue.

I have pet insurance with a cancer rider on Newton. So cost was not really a factor in my decision to pursue a clinical trial. Since the cause of cancer in dogs is largely unknown, I feel that it is important (given the opportunity) to contribute to finding the cause and more effective treatment.

Following the bone scan, a Radiologist talked to me, but an Oncologist didn't. I was told that I needed to schedule an Oncology Consult. I had thought that is what I had done when I had booked the original appointment at CSU (at least that is what I was told), but it didn't appear to be the case. The thing that I learned is that you have to be very specific with the folks who are scheduling the appointments. What I should have booked was 3 appointments for a single day: Oncology Consult, Bone Scan, and Follow-up Oncology Consult.

Today, we were greeted by Katie Kennedy (a 4th year student) and 2 vet students visiting from Japan. They conducted a physical exam and took down Newton's history. Then, Dr. Ehrhart met with us. Dr. Roberts had provided me with a disk of Newton's X-Rays. Dr. Ehrhart said that based on the X-Rays and the bone scan that she was 85% sure that it was Osteosarcoma.

Dr. Ehrhart laid out the various treatment options and prognosis. Due to the location (proximal humerus), Newton is not a candidate for limb-spare. She also talked about palliative treatment, amputation, and chemotherapy. One of my concerns is if a giant breed would do well with only 3 legs. She indicated that Newton would make a good amputation candidate based on his body structure, especially since he has a fairly narrow chest.

CSU has some clinical trials that they currently have going on that Newton may be a candidate for, so Dr. Ehrhart had Dr. Momont discuss the clinical trials with me. I got a degree in Biochemistry and know the value that clinical trials can have for treatment in the future, so it was something that I inquired about.

The three Dr. Momont discussed with me were: Gene therapy for Canine Osteosarcoma, Stereotactic Radiosurgery for Treatment of Osteosarcoma, and Radiation Therapy with or without Bisphosphonate for Palliative Treatment of Canine Osteosarcoma.

I was surprised that I was not more upset when Dr. Ehrhart told me that she suspects Newton has Osteosarcoma. I guess that I prepared myself a bit before the second set of X-Rays. I have to do what is right for Newton. He needs to be happy and comfortable. So, now I am faced with the challenge: how do I want to proceed???