We've hit a setback

The U.S.-Canada border in northern Minnesota. (MPR Photo/Bob Reha)

Tomorrow marks Rilley's second full week since his brain surgery and we've run into a potentially serious setback.  There is a bureaucratic roadblock that is preventing the Ohlfest Brain Tumor Lab from shipping his vaccine.  Apparently the Canadian Government won't allow the vaccine into the country without regulatory approval from some form of Veterinary agency (we're not sure what that exactly means).  While there are people at the University of Minnesota, the Mississauga Oakville Emergency Hospital as well as Rilley's own vet doing their best to help this is really worrying us.  The vaccine is the key component to his treatment.  Without it the tumour will eventually come back, making all of the effort done so far seem like it was for nothing.  We are hopeful that someone on either side of the border will be able do something to get this moving but all we can do for now is wait.

Tomorrow, the stitches come out!   But the vaccine can't get past the border.

The First Vaccine is in the Works!

It may be a Sunday, but we just got word today that things have been set in motion for Rilley's first vaccine from Dr. Ohlfest's Brain Tumor Lab!  The lab will be shipping it directly to Rilley's regular vet office and Dr. Ewing will be administering it herself.  Rilley has an appointment this Thursday (exactly two weeks since his surgery) to have his stitches removed so we have our fingers crossed that his vaccine will avoid any hang ups at the border so that it can be here in time.  We are very excited!

Our girls and their favourite pooch!
They are a big part of the reason we sought out the clinical trial at the University of Minnesota.

Back To His Old Self....

We've been worried the last few days that Rilley wasn't quite himself. Trust me he has certainly had no trouble eating us out of house and home, but one of the things which I truly enjoyed before the surgery was talking him for a morning walk with my coffee after dropping the girls off at school in the morning.

Now I know it has only been a little over a week since his surgery, but he almost seemed to be hating being outdoors. We were noticing that sunlight bothered his eyes to the point that even when he sunbathed at the front door he would make sure his back was in the sun and not his face.

I am happy to report that it appears this was a temporary side effect and this afternoon Roy & I were able to enjoy a beautiful walk with him. The funny thing was that he dictated where we walked to and he led us to the vet's office.

It is so wonderful to have our Rilley back and be able to enjoy all the things that we did before with him.

Sara, Rilley and our eldest daughter.

One week out....

Rilley sleeping on the floor with one of his favourite stuffed animals.

Today marks exactly one week since Rilley had his brain surgery to remove the meningioma.  As you can tell from the photo above, he is doing just fine.  He is even beginning to grow some "peach fuzz" on his bald head and the incision is healing nicely.  The stitches will be removed in one more week, around the same time he will receive his first dose of the custom made vaccine.  When Rilley was discharged from the veterinary hospital, we were given instructions to keep him as still as possible and to not allow him to jump on and off the bed, nor to take the stairs.  Well, all we can say is...we've been trying, honest we have, but it is becoming extremely too difficult to stick to all the rules.  Regardless, he is continuing to recover very nicely.

The Crazy Cost of Medications

As a result of the lab work done in Minneapolis that revealed Rilley's high liver enzyme levels we have begun to back off his Phenobarbital and introduce his new anti-seizure medication Keppra.  We were warned that the new medication would be more expensive than the Phenobarb and how true that is!  To give you an idea, when Rilley was first put on the medication, we purchased 500 tablets of the Phenobarbital for roughly $84 CDN, this would last us around 100 days.  Conversely, 100 Keppra tablets cost $154 CDN and these will only last 22 days and he will be on this medication for the rest of his life.  If only I could add Rilley to my work benefit plan!  ;^)

Searching online Sara discovered that we could order 100 tablets of the generic version for just $28 USD but the online pharmacy doesn't deliver to Canada.  The ironic thing is, the pharmacy is located in Canada!  Surrey, BC to be exact!  Tell me that's fair!

Granted, Rilley will soon be completely off of his steroids, which is a very good thing, but the cost of that is negligible in comparison.

The results are in...Rilley's tumour has been graded!

We received a call from Rilley's local vet tonight.  Dr. Ewing had been speaking with Dr. Pluhar in Minneapolis and Rilley's tumour has finally been graded.  When Rilley had his surgery last Thursday, it was thought that because the tumour had grown so much and had begun to attach itself to his brain that it would receive a grade of II or III. 

For reference, World Health Organization (WHO) defines the various grades of a meningioma as follows:

Rilley before surgery with his original MRI superimposed.

Grade I: Benign Meningioma

Grade II: Atypical Meningioma

Grade III: Malignant (Anaplastic) Meningioma

Obviously we've been hoping that the tumour would not receive one of the higher grades...so, drum roll please!

Rilley's meningioma tumour is a ...GRADE I!!!!

We cannot say how relieved we were to get this news!  It means that it is the grade of meningioma that has the lowest risk of recurrance.

The long and winding road...a reflection on our first trip to Minneapolis.

Driving down the endless road!

So the long road home gave us time to reflect on everything that has happened since our departure last Tuesday evening.

Travelling home:
Having a rest in Wisconsin, the state that never ends!



When we originally arrived in Minneapolis we pretty much rolled right into the parking lot at the Veterinary Medical Center and walked straight into the pre-op appointment which included the presence of the Daily Planet camera.  As you know from the post that day we were incredibly tired and it took a lot of concentration to focus on the discussion.  We didn't have the camera there to get ourselves on TV, we simply want everyone to know of the incredible work being done in Minneapolis to help find a cure for brain tumours in dogs and humans alike.  We must thank Director of Photography Jay Kemp and Producer Michelle McCree for making sure that the camera was there to record the events without being intrusive.  Honestly, we can't say that we really noticed the camera at all and the appointment ran very smoothly.  We were extremely excited for what the following day would bring.



Asleep on the long ride home


Everyone expected Thursday's surgery to run smoothly as all the preparations had been in place for some time.  Dr. Pluhar had the original MRI scans that were done at the Mississauga Oakville clinic and all of Rilley's medical history (related to the tumour).  Even the physical exam done during the pre-op appointment was normal.   We received regular updates via Brian, the communications point-person for the television production crew.  Then when Dr. Pluhar came out while Rilley was moved from the OR to the MRI she told us that things had not been as simple as had been expected.  It seemed that everyone was shocked to learn that the tumour had grown much quicker than expected and that it had begun to attach itself to Rilley's brain.  Dr. Pluhar had hoped to remove the tumour in one complete piece, but given this new development she had no choice but to cut it into pieces in order to remove it.  This gave us a dose of reality and the true weight of Rilley's predicament began to sink in.  While it turned out that Dr. Pluhar skillfully removed the tumour despite the increased difficulty we realized that had we not made this journey, our beloved Beagle would have only survived for another week or two.

This development made a lot of recent events make sense.  Within the week previous to our departure Rilley had numerous seizures in greater frequency and he had begun to lose some control over his bladder.  We had actually commented that something seemed wrong and that things appeared to be getting worse.

Thankfully, we got to Minneapolis in time for the tumour to be stopped.  Dr. Pluhar literally ended up saving Rilley's life.  It appears that the only consequence to the change in his tumour is that it of a more serious grade.  We are still waiting to find out what grade of meningioma the tumour is but it doesn't change Rilley's course of treatment.

Dr. Pluhar getting Rilley
ready to be discharged

In two weeks, Rilley will have his stitches removed and he will receive the first of his vaccine injections.  The vaccine takes two weeks to develop and will be shipped directly to Rilley's regular veterinarian, Dr. Stephanie Ewing.  She has kindly agreed to administer the shots.  Luckily, Rilley loves Dr. Ewing, so he should be pretty happy to go see her on a regular basis.  He will receive an additional five rounds of vaccinations at two week intervals.

We also learned during our visit that Rilley's liver enzymes were at extremely high levels, most likely due to the Phenobarbital anti-seizure medication that he has been on.  This will now be replaced with another anti-seizure medication called Keppra which is not processed as intensely by the liver.

Rilley will be making return trips to see Dr. Pluhar at the University of Minnesota in three, six and twelve months for follow up MRIs and blood work.  But for now, he seems to be happy, healthy and back to his old self...causing trouble.

We're home, finally!!!!

After nearly 20 hours on the road (construction, doggie-breaks, wrong turns, etc.) we are finally back in Georgetown.  We're off to bed and will update the blog in the morning.

Goodnight!