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The Scottish Terrier's War On Terror
Carole Fry Owen, GSM 'MacAnswers' Columnist
"Spread your arms. Spread your legs," airport security told me. As they patted me down and examined my shoes and cameras, I thought how appropriate the search was. I was on my way to a War on Terror, the Canine Cancer Seminar in Sacramento, CA. From the point of view of a cancer cell, I would be a terrorist. I should be stopped. Fortunately security missed me, and I hope my words will inspire you to join the guerilla warfare against cancers in our dogs.
San Francisco Bay Scottish Terrier Club's (SFBSTC) Canine Cancer Seminar April 6, was a seminal event. The most ambitious educational program ever undertaken by an area Scottie club, the seminar marks the first educational grant from Scottish Terrier Club of America's Health Trust Fund (STCA HTF)! HTF had previously awarded only research grants. Generous Scottie owners, including GSM readers, are making expansion of funding possible.
Approved to veterinarians for 7.5 Continuing Education Hours by the American Association of Veterinary State Boards, SFBSTC's Canine Cancer Seminar brought together some big guns, true 105 Howitzers, in cancer research and treatment, and was orchestrated with a $12,000 budget. Nearly 70 dog owners and veterinarians attended, from California and as far afield as Virginia, Texas, Washington, Nevada, Indiana, Colorado and Maryland. Bouvier des Flandres, Saluki, Bermese Mountain, German Shepherd and Shiba Inu owners joined Scottie fanciers.
STCA's Health Trust Fund granted partial seminar funding of $6,000 to SFBSTC. Actually though, almost all expenses were covered by the California club itself since one of its club members anonymously donated $5,000 of the $6,000 to HTF and earmarked it for the seminar. The club's own treasury, other sponsors and registration fees fleshed out the rest of the budget. Besides STCA HTF, sponsors included Hills Prescription Diet, Universal Medical (ultrasound machines), Accu Vet (laser surgical equipment) and Great Scots Magazine. An application for support is pending to American Kennel Club's Canine Health Foundation. Dedicated to Kati
Kati, Elizabeth Wise's Scottie that died of bladder cancer in October, 2001, lives on with her story in the seminar Proceedings. The event was dedicated to Kati's memory. Wise returned from work two years ago to discover her kennel floor in Sparks, NV, covered with blood: "It looked like a war had taken place." Wise's and Kati's battle against cancer began that day. Kati's ordeal fueled Wise's fire to learn more about cancer and to fight it in our dogs.
The idea for a cancer seminar was born in 2001, and Elizabeth became its chairman. Head cheerleader was club president Ross Buffington whose Scottie, Kati's son, now also has bladder cancer. Fellow Californians Dick and Joyce Eglin handled registrations, and club webmaster Gerry Meeder recorded images of the seminar.
Special guest was Barbara DeSaye, Lapeer, MI. The San Francisco Scottie club was established in 1966 in the living room of Barbara and husband John DeSaye in Hayward, CA.
How appropriate at this marshaling of the cancer forces to see Marion Krupp's patriotic Scottie "Trying to Understand" greet attendees. Krupp donated two of her popular prints for a silent auction to benefit HTF's cancer research. Joseph and Charlotte Harvill, GSM publishers, donated many copies of the issue that carried "Death Takes a Holiday," Karen Williams' gripping story of her Stormy and bladder cancer. It was Best Article in a Single Breed Magazine in Dog Writers Association of America's 2000 contest.
"We are on a crusade. Cancer is a gut wrenching experience for all of us who have been through it," moderator Dr. Marcia Dawson opened the seminar. I could envision all us Scottie owners fidgeting in night vision goggles as we waited for marching orders against cancer. Dawson, a Scottie owning veterinarian from Danville, IN, is STCA HTF chairman and an STCA Board member. She's a qualified commander-in-chief whose own first Scottie had bladder cancer.
Dr. Maureen Adams, Elizabeth Wise's primary veterinarian, and Dr. Cathy Connelly, both of Reno, NV, presented a case study about Kati's diagnosis, treatment and eventual surgical removal of bladder cancer by laser. Dr. Connelly and Wise have a special place in my heart because they also helped Garth, a wheaten Scottie I bred, in his later stages of bladder cancer. Wise hosted his owner Ellen Perkins from Las Vegas, in her home, and Dr. Connelly excised Garth's tumor by laser.
Major Cancers in Scotties
It is undeniable that Scotties have a greater chance of developing some cancers than other dogs. Though written 16 years ago, the classic article on the subject is "Hospital Prevalence of Cancer in the Scottish Terrier" by National Cancer Institute's Dr. Howard M. Hayes. Published in the 1986 Handbook of the Scottish Terrier Club of America, its information came from the Veterinary Medical Data Program, which then had the largest repository of veterinary clinical data in the world, with information banked from 18 universities.
Six cancers for which Scotties appeared more at risk (in descending order) compared to other purebreds were bladder and other transitional cell carcinomas (TCC) of the lower urinary tract, malignant melanoma, gastric carcinoma, squamous cell carcinoma of the skin, lymphosarcoma and nasal carcinoma. Within our breed, the most frequent Scottie cancers (also in order) were lymphosarcoma, bladder cancer, malignant melanoma, mast cell sarcoma, hemangiosarcoma and squamous cell carcinoma of the skin.
Let's tackle lymphoma first. Lymphoma presenter was oncologist Dr. Bruce Madewell, president-elect of the American College of Veterinary Internal Medicine. If you've had a Scottie with lymphosarcoma, translate that also as lymphoma. Dr. Madewell classified the two disease terms as one. Drugs to treat lymphoma in dogs and non-Hodgkins lymphoma in humans have been around for 30 years. Prednisone, cyclophosphamide, vincristine, L-asparaginase and doxorubicin "remain the mainstay of most modern chemotherapy protocols for canine lymphoma," stated Dr. Madewell.
COP, CHOP, COPA and six other published protocols were mentioned by Dr. Madewell. Different oncologists have pet preferences for combining and timing the arsenal of lymphoma drugs. Dr. Madewell can provide your veterinarian with University of California lymphoma protocols. Also, see "Diagnosis, assessment of prognosis, and treatment of dogs with lymphoma: The sentinel changes (1973-1999)," B. R. Madewell, Journal of Veterinary Internal Medicine, 13:393-394.
What's changed over three decades is refinement of chemotherapy protocols and development of "rescue" or "salvage" therapy for secondary treatment. New methods of identifying a tumor's clinical stage and substage, histologic grade and immunophenotype also provide clues to how a particular dog will respond to chemotherapy. Knowing such odds is vital to owners who must decide whether to treat lymphoma, or not treat.
Treating lymphoma is expensive. Dr. Madewell estimated a $3,000 to $4,000 cost to treat a Scottie with lymphoma. The drugs are very expensive, tedious to administer, and much lab work is necessary to evaluate the disease and monitor a dog's treatment. "Remission is achieved in the majority (greater than 75%) of dogs given chemotherapy, and although survival times usually exceed one year, cure remains elusive," stated Dr. Madewell.
Fina is the most amazing Scottie success I can recount for such chemotherapy. She's an unusual case. Owned by Jorge and Pat Torrejon, Surrey, B.C., Fina was diagnosed with lymphosarcoma in 1987 at age 3, took 12 weeks of chemotherapy, and was maintained on prednisone for the rest of her life. Fina lived in remission for nine years, and died at age 12. If anyone can top that, let me know.
Treatment innovations Dr. Madewell mentions are chemoimmunotherapy (stepping up traditional chemotherapy with use of certain cancer specific antibodies) and half-body radiotherapy.
There are diet innovations for lymphoma and other cancers, too. Hill's n/d is a cancer diet high in protein, arginine, fat and Omega 3 fatty acids, and low in carbohydrates. Dr. Madewell mentioned a recent study showing that menhaden fish oil and arginine combined with a low carbohydrate diet increases the remission and survival time in dogs with certain lymphomas.
Hill's Prescription Diet, one of the seminar's sponsors, had its area representative on hand with Hill's excellent free booklet "Management of Canine Cancer" and brochures on n/d including, "Cancer, New Hope." For the publications, contact Hill's 1-800/892-4621.
Environmental factors influence risk for lymphoma. Take care what goes on your lawn. Although recently challenged, one study correlated exposure to the herbicide 2, 4-D with a twofold risk of canine lymphoma. Our Scotties are already at increased danger simply because they are Scotties. Don't add to it.
Dr. Jaime Modiano is an energetic guy, young and muscled. The afternoon before his presentation he rode 18 miles in training for a 480-mile, week-long mountain bike race he and his wife Dr. Michelle Ritt have entered. He puts just as much energy, fun and muscle into his cancer research at AMC Cancer Research Center, the University of Colorado, Colorado State University and the Donald Monk Cancer Research Foundation. Dr. Modiano is one of our own Scottie researchers. STCA's HTF helped fund his Canine Health Foundation grant, "Significance of Tumor Suppressor Genes in Canine Cancer."
Dr. Modiano "call me Jaime"loves dogs, research and people. His wife's Gordon Setter and her curiosity about why the pet kept sprouting melanomas was the original inspiration for their melanoma and tumor suppressor gene research. Dr. Modiano's wife is a board-certified internist, and he calls her "the engine behind the project." Major hypothesis of their studies has been that certain suppressor genes when mutated can't do their protective jobs, but leave the body defenseless against the rogue cells of melanoma.
"All the cells in a tumor are clones. They arise from one cell, and they forget to die," simplifies Dr. Modiano. "They're like guys coming into the New York subway...Excuse me, excuse me," as they butt their way in.
Prevalence of malignant melanoma is higher in Standard and Miniature Schnauzers, Doberman Pinschers, Scottish Terriers, Irish and Gordon Setters and Golden Retrievers, according to the scientist. Breeds at higher risk for melanoma are usually ones with pigmented skin or mucous membranes.
Though 20% of all skin tumors are melanoma, most are benign. Benign melanoma? Sounds like an oxymoron, but I discovered it's true when an ugly melanoma on my Lucky's neck biopsied benign. She lived for years after its removal. Dr. Modiano says malignant melanomas usually are in a dog's mouth, eye, the nail bed or pads of the foot. Unlike human melanomas, malignant canine melanomas most often hide in areas "where the sun doesn't shine."
Gene therapy is in Research and Development for canine melanoma. It's only experimental yet, but Dr. Modiano has completed a small and very successful trial on gene therapy. Dr. Modiano's slides pictured a Shepherd cross with a ghastly oral melanoma. The remarkable "after" photo seven days following gene therapy showed the melanoma had almost melted away! Dr. Modiano is co-investigator on a National Institutes of Health application to fund the next step in this innovative gene therapy research that could mean so much to humans, and Scotties. His wife, Dr. Michelle Ritt, will be principal investigator.
Scotties are 18 times more likely to develop bladder cancer than other breeds. It's so common that moderator Dawson urged: To vets"If a Scottie walks in the door with blood in the urine, it is bladder cancer until proven innocent!" To owners"Don't let a vet treat for cystitis first. Say, `I want an ultrasound.'"
Symptoms of TCC are blood in the urine, straining to urinate, and frequent urination. These are exactly the same symptoms for urinary tract infections. Scottie owners, be wary.
I recently discovered what a friend ultrasound is when our 11-year-old Grande was ultrasounded to explore liver abnormalities. The ultrasound showed chronic hepatitis, but the kicker was: she also has a sizable bladder tumor. Diagnosis was five months ago, and Grande still has no physical symptoms of either condition. No telling how long her bladder tumor would have remained undiscovered if not for ultrasound.
Though bladder cancer comprises only 1% to 2% of all canine cancers, if you're a Scottie owner, be ready for it. Figures show Scotties are freakishly above any other breed in incidence of bladder cancer. With mixed breeds having a baseline risk of 1.0 for bladder cancer, Purdue University researchers say purebred dogs have a 0.74 risk. High risk breeds are: Scottish Terrier: 18.09; Shetland Sheepdog, 4.46; Beagle, 4.15; Wire-Haired Fox Terrier, 3.20; West Highland White Terrier, 3.02.
"The most common kind of bladder cancer is transitional cell carcinoma of the bladder (TCC)," noted researcher Dr. Deborah Knapp, Purdue University School of Veterinary Medicine. "TCC usually occurs in older dogs (average age 11 years) and is more common in females (2:1 ratio of females to males).
Dr. Knapp is principal investigator on "Characterization of Host and Environmental Risk Factors for Urinary Bladder Cancer in a High Risk Breed (the Scottish Terrier)." Through STCA's Health Trust Fund, Scottie owners are providing $30,000 of this $60,000 AKC Canine Health Foundation two-year grant.
"AKC reviewers said we could never find 50 Scotties with bladder cancer," smiled Dr. Knapp. "We already have 66 Scotties, plus 66 unaffected control Scotties. We want 100 of each." Participants can complete study questionnaires until May 15. If you have a Scottie six years or older, with or without bladder cancer, please help. Time is short. Contact Dr. Dawson at 317/852-4393; e-mail: email@example.com; or Ms. Patty Bonney at Purdue, 765/494-1130; e-mail: firstname.lastname@example.org.
Piroxicam is the non-steroidal anti-inflammatory (NASAID) drug that is first line treatment for most dogs with bladder cancer, thanks to Purdue research which began in the early 1990s. Many Scottie owners think of piroxicam as a miracle drug.
"Piroxicam allows the cancer cells to kill themselves, and we're trying to figure out why," related Dr. Knapp. "Some of the most important discoveries in science are accidents, and piroxicam for cancer was an accident! I was treating my Pointer which had tumors in the lung and gave him piroxicam to make him feel better. The tumors went away. He died of megaesophagus, and had no cancer on autopsy!"
Piroxicam must be "compounded" into the correct dosage. Most pharmacies don't compound, so it was interesting to visit the seminar display of David Vasenden, R.Ph., a compounding specialist. His brochure "Compounded Medications" is very imformative. For information on compounding piroxicam, call Vasenden (Reno, NV), 775/329-2000.
Surgery is a consideration for TCC. Usually it's not an option because the tumor is in an inoperable areamost commonly in the neck of the bladder or has spread down the urethra. Purdue is reviewing records to determine if surgery aids treatment. Radiation therapy has too many side effects, including incontinence.
Chemotherapy for TCC has been disappointing, but carboplatin or mitoxantrone, either one combined with piroxicam, may improve remission times and are under study. Dr. Knapp recommends against cisplatin/piroxicam combinations because of kidney toxicity. Piroxicam alone remains the best bet for most Scotties.
How can you help? Dr. Knapp encourages owners to participate in Purdue's current Scottish Terrier case/control study, provide DNA samples and pedigrees for genetic studies, participate in clinical trials where available, provide tumor biopsies from necropsy, and support fundraising and education.
Dogs Help Humans
Indiana University's clinical trial of cox inhibitors (i.e. piroxicam) in people with high grade bladder cancer is harbinger of the future: "Two of the first four patients enrolled have had complete remission of their cancerand this is after they had failed to respond to `standard treatment!'" reported Dr. Knapp. A thrilling part of the cancer seminar was the repeated proclamation that research on our Scotties will help humans; and research on humans will help our Scotties. Dr. Fredrick Leach, senior staff urologist and principal investigator for National Cancer Institute's Urologic Oncology Branch, has a special interest in hereditary bladder cancer. No one could miss his excitement at the fact that dogs, especially Scottish Terriers, may unlock answers to cancer in humans.
Canine TCC is like the aggressive form of bladder cancer in people. Dr. Leach is sure that dogs provide a good model for his bladder cancer research, and that bladder cancer research using canines will be a good model for other cancer studies.
Dr. Leach's Canine Hereditary Urothelial Malignancy Study, or CHUMS, is off the ground. He already has collected 105 DNA samples from dogs with bladder cancer and their relatives. "Approximately 40% are Scotties, and many of the Scotties are littermates. Obviously we are targeting Scotties."
Windfall for Scotties is that we will learn the genetics behind hereditary bladder cancer, which TCC appears to be in Scotties. Human health research is where the big money is. Dr. Leach has asked for no money from dog owners. He needs DNA. Let's help!
I sent DNA blood samples and a pedigree from my Grande who has bladder cancer. Please join me. (See Dr. Leach's contact information.) My veterinarian collected and processed the blood at no charge, and Dr. Leach's research account paid for next day shipping. Sending DNA on Grande cost me nothing. Since it's for research, perhaps your veterinary may "no-charge" you, too.
Pedigree analysis of the mode of transmission of bladder cancer may be in the offing by a canine geneticist. It's under consideration by STCA's Health Trust Fund.
"Our Scotties are ornery, tough, stubborn. They have heart. Scottie owners are a lot like our dogs," bragged moderator Dawson. "We have heart, and we are not going to give up the fight against cancer!"
Our nation's dogs start each day with the same innocence as did 3,000 of their human friends September 11. As America closes in on those terrorists, it's exciting that researchers also are closing in on canine terroriststhe cancers that strike our pets. Meanwhile, we Scottie owners will continue "Trying to Understand."
Internet Sites for Canine Cancer Information
Veterinary Cancer Society:
Canine Cancer Seminar Presenters and Resources
Bruce R. Madewell, VMD, MD, Dept. of Veterinary Surgical and Radiological Sciences, University of California School of Veterinary Medicine, Davis, CA; e-mail: email@example.com
Jaime F. Modiano, VMD, PhD, AMC Cancer Research Center, 1600 Pierce St., Denver, CO, 80214; ph. 303/239-3408; e-mail: firstname.lastname@example.org
Deborah W. Knapp, MS, DVM, Dept. of Veterinary Clinical Sciences, Purdue University School of Veterinary Medicine, West Lafayette, IN
Fredrick S. Leach, MD, PhD, National Cancer Institute, 10 Center Dr., Building 10, Room 2B47, Bethesda, MD 20892-1501; ph. 301/402-6507; e-mail: email@example.com
Maureen Adams, DVM, Bonde Lane Animal Hospital, 6474 Bonde Lane, Reno, NV 89511; ph. 775/851-3151.
Cathy Connelly, DVM, Community Animal Hospital, 5150 Mae Anne Ave., Suite 404, Reno, NV 89503, ph. 775/746-0333
Marcia Dawson, DVM, Chairman, STCA Health Trust Fund, 3220 N. County Rd. 575 East, Danville, IN 46122; ph. 317/852-4393; e-mail: firstname.lastname@example.org
Barbara DeSaye, past Chairman/current trustee, STCA Health Trust Fund, 2702 Pensicola Ct., Lapeer, MI 48446; ph. 810/667-0942
Elizabeth Wise, Chairman, San Francisco Bay Scottish Terrier Club Canine Cancer Seminar, 5545 Wedekind Rd., Sparks, NV 89431; ph. 775/356-6519; e-mail: email@example.com
©2002 Carole Fry Owen
©2002 Tartan Scottie. Reprinted from Carole Fry Owen's "MacAnswers" page Great Scots Magazine Vol 7 No 3, May/June 2002.
©2001 Tartan Scottie. All Rights Reserved