So it has been 1 week today that Marshall was laid to rest. It has been hard on all of us including Madison.

The other night I went to get a glass of ice. Marshall would always be there with steam coming off his big ol nose as he would stick his head in the freezer waiting for me to give him a piece of ice. He wasn’t there.

Last night we ordered pizza and sandwiches. I ordered a Brooklyn to eat later in the night. I would often do this but since Marshall had lost weight he discovered there were a lot of goodies for the taking on the counters when nobody was looking. This included many a times I would go into the kitchen to get me some cold pizza only to find an empty box! It took him some time to train us that the only safe place for food was on top of the refrigerator. So last night I went to set it up there…then it hit me…there was no need too.

Earlier in the day after church it was a rainy day and I went to crawl in bed for a good nap. But my mind couldn’t rest as I realized my cuddling buddy wouldn’t be snuggled up to me.

Coming in the house once required bracing yourself for a 140 pound dog charging you. He and Madison would greet you as if we were the New York Yankees in a ticker parade after winning the World Series.

Now opening the door is just another reminder that Marshall was no longer with us. Even when the sky is bright with sunshine a misty grey cloud hovers over us.

Dr. Ed Sullivan – Linear Accelerator - Allogeneic Transplant

These names and terms had never entered my mind much less my everyday vocabulary. These words and terms like “genetic marker” and “molecular markers--called cytogenetics” all came in focus from a simple lump in the throat of Marshall. I will never forget the evening I arrived home after spending a week in Ann Arbor and the Domino’s World Resource Center. I lay in the floor wrestling with the giant lovable and huggable friend that loved me every day of our 4 year relationship. This loyal loving dog crawled in my bed with me the night my Dad passed away…he knew I was deeply saddened. He was with me during a time when my very reputation and who I am came under attack. He welcomed me home every day…he knew I was in need and he was there. As we wrestled my hands would always grab his block head and I would tell him “I love you boy” “you are my good boy” and he would wrestle his head away and rub his head over my face and checks telling me “I was his” and that he loved me too. But this time I froze and looked to Judy and back at Marshall. “I feel something in his neck” I said. Slowly we calmed Marshall down and I confirmed the instant fear. There was in fact a lump I had never felt before. Judy had to feel as well. She being the optimist dismissed it but agreed we would need to get him to Dr. Parks the next day.

Dr. Parks face upon feeling them confirmed this was potentially something not so good. Though we talked about giving some anti biotic and maybe it was just an infection. We also discussed if they didn’t come down what next? Then we would need to do an aspirate and send off for testing. Judy and I both knew we didn’t want to wait. So we asked that we go ahead and do the aspirate. 2 days later on Thursday evening at Moms home the call came in…Marshall has cancer.

What do we do? Is there anything you can do? Questions rush through my mind. As it goes in this world of today I would hit the internet seeking answers. Thus Google began the journey that would eventually lead Marshall & Me to Auburn University and then to the state of Washington.

I didn’t even know dogs got cancer! I guess I did but of all the pets we had and namely dogs we never experienced it nor did I recall anyone else having faced this. We immediately went to Auburns website knowing the reputation of having a great veterinarian program. We were on the phone quickly and had an appointment on Monday. I worried all weekend because my buddy had cancer and we were doing nothing. I was afraid it would be too late by Monday. I continued searching Google looking for good news anything that would ease all of our fears…fears of the unknown. I came across a Doctor at Wisconsin-Madison and emailed her. To my great surprise I quickly received a response and the words jumping off the laptop monitor were comforting and gave hope. I would remain in contact with Dr. Robat up until even now. She offered so much of her time and advice. I will forever be grateful to her (and many others I would also find during this journey) while Auburn treated Marshall Dr. Robat treated me in a way. The unknown is a powerful force. It can bring about pain and hopelessness that can lead to actually physical pain. I had learned 2 years earlier that death brings about great emotional pain but was shocked to discover there was a physical pain unlike any other pain I had ever experienced. While different I did have a physical pain in my gut. Dr. Robat was able to treat that with simply taking time to re assure me.

One thing that was so concerning to me was site after site talked about how Lymphoma was very common and it responded to treatment very well. Yet the average life expectancy was 1 year. I couldn’t understand how this could be considered success. Of course at the same time without treatment Marshall would be dead in 2 to 4 weeks! It would be some time later before I would engage this conversation that being how was 1 year considered so successful? My boy was only 4 years old and success will be living to 5?

These thoughts would later lead me to continue searching the Google world for something more than 1 year. All along we prayed and hoped that Marshall would be the exception and he would live beyond the 1 year death sentence. My world was rocked just several weeks later when we were told Marshall was out of remission. My mind raced with thoughts of how could this be? He went into remission after just 2 treatments. Heck after his first treatment within 24 hours I could barley feel the lumps in his neck I had previously felt. How can this? There is no answer as to why some dogs go into remission and stay for months and even some years. I would find a yahoo groups support group for dogs and their owners with Lymphoma. But all too often I was reminded some dogs were not afforded the same fate.

So Google lead Marshall & Me to Dr. Sullivan. I read about Comet the first dog to receive a bone marrow transplant and how he went on to live a normal active life. I read article after article about Dr. Sullivan and Comet. From papers around the country and the world. Soon I would find myself speaking with this man who is so many ways had made history and I was now talking to him and as you know eventually I was 3000 miles from home shaking his hand. I would talk to Comets owner a very successful attorney in Washington. I thanked him for his willingness to be the first. For I knew then and even though Marshall never made it that far I know still that the answer to this horrible disease is in bone marrow transplants. Without Comet and his owner and of course Dr. Sullivan the 1 year death sentence would stand. Though let me point out that the Universities and human researchers had been working on this. In fact with absolute certainty if it were not for dogs there would not be the success of human transplants that cure thousands every year. So in the same manner Marshall would be number 7 and if it were not for Comet and 5 other dogs and owners Marshall and Me would be out of options.

So it was that same Google that brought me to Dr. Sullivan that also brought me to a point in which I examined my own commitments to helping not just dogs, pets and their owners but humanity. Perhaps one of the most humbling events or actions that transpired was when we had to reach out to find Marshalls relatives to seek matching results in hopes that Madison would be able to be Marshalls donor. Every single person we spoke to offered their support and help. They each were moved to action. They went out of their way to immediately get blood samples from their vets. I will later speak in much more detail on this. It was the critical and most important aspect of the whole thing. Without these willing dogs and owners Marshall had no hope for a transplant. I can never express my gratitude in words to these people.

This was written by my representative in Denver from one of my print suppliers. She is animal lover and has been following Marshall and Me and our journey since the start. 

Marshall’s Eyes

A tender, caring heart

Deeply connects with others

Creating a bond rarely torn apart

Not everyone is so Blessed

To give and love unconditionally

Causing others to wonder and protest

For they’ve not truly shared

Their own heart and soul

To know the rewards from those who have cared

Do not be ashamed of

Looking into Marshall’s eyes

And see His gift to you was Love.

Laurie L. Lawrence

August, 2008

I want to first apologies for the abrupt stop of updates to the blog. I honestly had no idea that so many were following. But mainly my heart was so heavy and my mind so locked up from hearing the terrible news that the cancer had entered the nervous system.

We left Washington on Wednesday afternoon heading for home. It was too be the last journey Marshall and Me would embark upon. I am not ashamed to admit that the tears flowed for thousands of miles and we heading back to Alabama. Marshall’s condition worsened each day. This began even before we embarked on the last leg of our journey.

The entire time in Washington Marshall and Me spent every minute of everyday together with the few exceptions of being separated while he was at Dr. Sullivan’s office. I would hand feed Marshall the week or so of his wonderful life. He was dependant on me for every aspect of life but the truth is I was depended upon him in my life. Though every aspect of my life were depended upon God’s strength and promise of hope.

Forgive me in that I don’t recall the day but at some point I noticed email notices on my cell phone. There were a flurry of emails from Dr. Sullivan and Doctors at Auburn and some I didn’t even know who they were. I notified Judy and asked her to take a look at what was going on. The jest of it was…it was not time to give up on Marshall. A test result came in that showed the cancer in Marshall’s blood was gone. Not one cell was discovered. This indicated that the therapy Dr. Sullivan had been using was working…and working remarkably well. To the bigger picture this would indicate the reason he would come out of remission so quickly was the newly discovered presents of the cancer in his nervous system. It may very well be the source.

Dr, Sullivan worked feverishly with other Doctors who specialized in radiation. There was one fairly new form of radiation that had been attempted with dogs and the results were very positive. So as we crossed the country the hope turned to Auburn who has the ability to administer this protocol.

 On Saturday along side I-90 as I pulled into a rest stop Marshall went to get up and immediately went into a seizer. Something I had never witnessed before not had he had previously. It was truly shocking and heart breaking to see. It lasted but a few seconds but it might have been 1 hour in my mind. With God’s guiding hand it just so happened at the next exit we would find a Veterinarian alongside the interstate. If you have not driven through South Dakota to be near anything is far and wide and of all places we just happened to find a Vet office open on a Saturday located next to the interstate. They quickly got Dr. Sullivan on the phone and a game plan was established. Marshall was given an injection and within minutes I witnessed Marshall recover in what can only be described as a miracle.

 With much thought we decided to go straight to Auburn to let them evaluate him. They would conduct an MRI which would help us determine if we were in fact too late. The truth is this was not new to his nervous system. I had been suspicious of this for several weeks. Unfortunately the problems Marshall experienced were written of to the prednisone he had been on. So I was fearful that since it had been in the system for some time that clearly all this time that had passed without the confirmed diagnoses I knew that time was not on our side. Let me be clear though that if it weren’t for our local Vet Dr. Laura Parks and for the doctors at Auburn this battle would have been lost months ago. While I wish they would have done more evasive test at the time when it was written off to be an ear infections and while the last day we rushed Marshall to Auburn before heading to Washington I know this was just an example of how much more research is needed to help improve care. Marshall was wobbling but unfortunately no test were done to explain this. It was thought it was just the progression of the lymphoma but as Dr. Sullivan would later finally discover Marshall had been telling us for 6 to 8 weeks (or more) it was in his nervous system. Would the outcome have been different? I believe it would have been but again there is no blame nesasairy. It is simply a horrible disease in which not enough is known. Again I am most grateful to all involved with Marshall’s care at Auburn.  

We went down the road to get another over the counter drug that was prescribed. I feed him and even his eating had made a stunning improvement. Though not perfect stunning nonetheless. Later at a stop he actually jumped in the car by himself with no help from me. Something he had not done in a week or 2.

By Sunday morning things had begun to change. He was lethargic but again was alert and flapping that famous tail around and eating well. Heading south on the interstate heading straight to Auburn he began to turn downward again. At each stop I couldn’t convince him to exit the car. So their he lay until we finally reached Auburn.

Upon arrival there was clear confusion on those at Auburn. For whatever reasons the wires got crossed and they didn’t even know Marshall was coming. We carried Marshall out of the car on a gurney.

Soon behind us Judy, Kalon and my Mom arrived and Marshall came alive. Clearly excited with seeing them. Life had returned to his allying body. We soon rolled him outside to get him down to see how his walking was and to allow him to go potty. He stumbled and fell. He did however finally make it so his feet and began to walk and used the potty. But for me no false hope built.

They would keep Marshall in the hospital with the plan being a MRI in the morning and to begin radiation. 

Though I disagreed with much of Auburns treatment I know they were trying what they could to help Marshall. I can’t help but think they should have caught this much sooner before the disease every advanced this far. But I also know mistakes happen and dwelling on it wouldn’t help anything. Today I do hope that they will recognize they missed this critical aspect of his care and will look closer next time. I had hoped to just hear the words acknowledging that they should have done further testing to catch this much much sooner. But I never heard those words and that’s ok. It was never about me and the words spoken today would have to impact on Marshall.

They prepared to do the MRI on Marshall to see the extent of the cancer tumor in his brain and on the spine. The test was stopped soon after they began. Marshalls breathing was wrong and the CO2 levels were rising. They had to bag him to breath for him. The sedation was simply too much for his body to handle. They placed Marshall on a ventilator as the Doctors consulted with us and with Dr. Sullivan as to what comes next.

I along with Judy and the advice from Mom and some others decided Marshall had finished his duty. It was time to give him the rest he so richly deserved. It was clearly a gut wrenching choice but I had no doubts in my heart or mind that it was the right thing to do. Marshall deserved to let be go.

So Marshall this dog of great importance who loved me every bit as much as I loved him was put to sleep with Judy and I holding him and telling him over and over that he was a great dog a dog that was a member of our family and will always be.

I cannot find words even in the deepest crevasses of my soul to express the deep sadness I feel and that Judy and our family feel. While our journey took us over 6000 miles in the last 3 weeks it didn’t begin there it began 4 years earlier as we met Marshall and Madison (his sister) in the middle of the night in west Alabama one fall evening. They play in the back of old truck bed as our eyes met for the first time and hearts wove together. That evening the journey began and while the journey led us to burring Marshall alongside the creek back at home as the sun was setting…the journey didn’t truly end for we will continue to work on finding a cure for this horrible disease. Marshall I hope has had a positive impact on future dogs and owners who will face these diagnoses.

Dr. Ed Sullivan is a man that is committed to helping animals. He is truly a gift from God given so much talent from God to help these wonderful creatures who I believe were also made wonderfully by our loving and compassionate God. Words can never express the gratitude we have for his devotion to Marshall and all animals. There is no doubt in my mind that Dr. Sullivan could have long ago left this field and entered into the MD practice and made millions. His heart is in the love of animals and with recognition that without animals and in particular dogs. He knows that without dogs tens of thousands of people will not have found their cure for cancer through bone marrow transplants. It is time it comes full circle.

God Bless him and his work and may each of you know that the journey isn’t over and that there is no such thing as “just” a dog. So while the journey with Marshall and Me together may have come to an end…the Journey will continue.

This morning Marshall is about the same. He hasn’t had any pain. He ate 2 cans of food. A couple from Canada has seen me spoon feeding him and today came and took pictures. We get a lot of folks asking about Marshall. He seems to bring a smile to their faces as he does mine. Yesterday at the clinic this women just keep staring at him and smiling. She finally said he has the cutest face. She said how old is he? I told her 4 and she couldn’t believe that he still had that puppy dog look about him.

So today we wait on Dr. Sullivan to call today. I assume we will be taking Marshall by for at a minimum a checkup. But for now we will wait for “The Call”. 

(If you havent read it please read the post below to catch up on what has taken place the last few days.)

The call came at 12:42pm local time. The cancer is in his nervous system and esitally his brain. Little hope remains. There is one last option and that is radiation targeting only the brain and then only the spine.

3000 miles from home we lay in snuggled in a bed together. I have no idea how I will ever make the trip back home. I simply can’t write any more.

I just received a call from Dr. Sullivan. It was not the news I thought today would bring. I had my hopes up so high. So much so that last night I began thinking of today’s blog title. To which it would have been “Happy Birthday Kalon”. Today Joseph Kalon turned 4. I am unable to be there but I had hoped to spread the news that Marshall was in remission and ready to begin the high dose therapy to get him into a deep remission and thus be ready for the bone marrow transplant as soon matching comes back on Madison.

But these hopes were not realized today. Rather I must report that at least one of his nodes had grown, not by much but grown none the less. The radiologist reported that he did see some inflammation but questions if that was enough to cause Marshall’s episodes with his limping and pain. Thus another attempt at a spinal tap had to be done. This time it was done at the other end of the spine in his neck area. They were able to draw some fluid. This has been sent to Seattle for testing which we hope to have back tomorrow. I guess I should say I am hoping I don’t know if this is realistic. I just want to know as it is going to be a very long night and try as I might the worry is filling my soul. As I picked him up at the vets office his feet flopped around but it was on hard wood so maybe that coupled with the sedation played into the mix. Once outside he was so wobbly that we laid on the side walk for some time. Elsa called Dr. Sullivan and had Hillary give him a dose of prednisone. They were able to see how hard of a time he has with eating. It is like his jaws are not working. This has in my opinion been steadily worsening over time. It has been attributed to the prednisone in the past but I believe with his legs this is becoming less likely as clearly something neurologically is going on. Though I still hope and pray that it is just side effects of the prednisone. He has become rather addicted to it and this could explain some issue.

So as we sit in the hotel room all the fears seem to be building like storm clouds gathering off in the distance. I have begun the process of thinking through when is enough…enough. I think about the long drive home should the worse news come. Not the distance home but rather the outlook of what is to come soon. It has been a long journey thus far but this journey I pray doesn’t end premature.  
 

So on this day of Kalon’s birthday we fight on for Marshall. You see Marshall is loved by all of us and this is certainly so for Kalon. This little boy of 4 years was taken from his parents at 5 months old as they chose the drugs over him. He was the center of a court battle between a state agency hell bent on seeing him as a number in a case log and that a policy should dictate his future. He lost his Paw Paw as suddenly as he lost his birth parents. He recently lost his granddaddy. All of this before the clocked struck midnight 4 years from his birth. Now as I said earlier the storm clouds seem to be gathering yet again. How does a 4 year old process the news over and over that their loved one has gone to heaven not to be seen until some future unknown time? I fear he will begin to question how great such a place is that he continues to lose too.

Last night at about 8pm or so Marshall had a bad episode with his front leg. Which we believe is actually a bad disk in his neck. He was in a lot of pain but we were able to get in under control. I don’t know how much this is connected to the cancer or treatments. It could be related to the prednisone he has been on.

It is sporadic and this morning he was feeling good.

Here is what Dr. Sullivan is thinking and planning:

Every since I first spoke with you there has been an underlying problem with Marshall's cervical spine.  I believe it is the cause of the wobbling he was doing before you left Alabama, as well as the cause of the intermittent episodes of severe pain and lameness on his front leg we have witnessed since you came here.  The most common cause of this type of cervical spinal pain is due to a bulging inter-vertebral disk in the space between the cervical spinal vertebral bodies.  The bulging disk pushes up and out to the side and pinches the nerves that go down into his front leg.  The pain can come and go suddenly depending upon how he lies on his side, how much activity he has had, and how he holds his neck.  A bulging disk could be the result of weakening spinal musculature and connective tissue from the long period of steroid use and chemo agents.  These changes may be reversible, or sometimes we have to do a surgery to remove a bulging disk and eliminate the pressure on the nerve roots.  There are a couple of other possible causes of this type of pain--such as some other source of inflammation of the nerve roots or some manifestation of lymphoma involving the nerve roots. 

Neurologic pain is sometimes difficult to diagnose, but we often start with a plain xray then follow up with a myelogram--a dye study of the spinal canal.  We will do an xray tomorrow morning, and follow with a myelogram if it is indicated.  Sometimes we cannot see anything with an xray or a myelogram and we have to order an MRI to diagnose a spinal or nerve root problem.  I hope we don't have to do this, but it may be necessary. 

I will give an update from today later tonight. 

UPDATE:

They did some x-rays today and a possible explanation appeared. Again I'll let Dr. Sullivan explain but basically there is an issue with a joint in his spine. There were several possible causes. At this time they are treating it as an infection. A radiologist is looking at the pictures and we will wait for more information on what if any other test should be run. 

It is unclear if this is related to the lymphoma.

Marshall’s blood numbers were looking a little better today so he should be on the upswing. I can tell he feels MUCH better today. 

The big question remains is he in remission or close enough to begin the High dose chemotherapy with autologous recovery. 

I hope we have a positive answer this week.