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Healing one of the family

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[Times photos: Ken Helle]
Miniature pinscher Anna Belle is held by owner Wayne Kauffman, right, as veterinarian Neil Shaw checks over her right front paw to see how well it has healed after radiation treatments for cancer.

By BABITA PERSAUD, Times Staff Writer

© St. Petersburg Times, published July 12, 2000


Radiation treatment is available to pets with cancer. A Tampa couple say the cost and trauma of the treatments were well worth it to help their Anna Belle.

TAMPA -- Anna Belle, the miniature pinscher, gets McDonald's french fries when she's good. On Christmas, gifts come packaged: To Anna Belle. From Santa.

At night, the whole family sleeps on the queen size bed: Kristy Kauffman, the mom, on the left, Anna Belle cradled in her arms.

Wayne Kauffman, dad, on the right, Ernie, the black Lab, stretched at his feet.

On weekends, the family likes to hang out by the pool at their New Port Richey home, as they did one day last April.

It was then that Wayne noticed the bump on Anna Belle's right front paw.

A trip to the family veterinarian, a three-day wait for test results and then the news: Anna Belle, 6, had a mast cell tumor, a type of skin cancer common in dogs.

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Wayne Kauffman nervously waits in the reception area of the Florida Veterinary Specialists and Cancer Treatment Center in Tampa while Anna Belle is treated.
A decade ago, the vet would have amputated -- or done nothing. The miniature pinscher, a breed which can live to age 15 or more, would have suffered an early death if the cancer spread.

Today, veterinary medicine offers radiation treatment comparable to the kind given to humans. The Kauffmans had three pages of questions for the veterinary cancer specialist they visited, including: Would the treatment hurt? Yes, the doctor said, but the pain would be short-lived. There would be no undue suffering.

Treatment would take place every day for three weeks. And the cost? About $3,200.

To the Kauffmans, the expense was justified. Wayne put off getting new rims and a paint job on his Harley-Davidson motorcycle. That seemed frivolous now. Anna Belle's health was at risk.

"If we had a child with cancer, we would do everything in our means to help her," said Wayne Kauffman, stroking his dog. "She's our girl."

* * *

The Kauffmans brought Anna Belle to Florida Veterinary Specialists and Cancer Treatment Center in Tampa, which uses a second-hand human radiation machine on cancer-stricken animals. It is one of two animal radiation centers in Florida (the other is in Miami).

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Anna Belle, a miniature pinscher, lies anesthetized on the radiation machine table before receiving another treatment for the mast cell tumor on her right front paw.
In a country that spends $27-billion annually on its pets, $12-billion of it on health care, it's little surprise that animals have their own cancer centers. Pets have completed their journey from the back yard to the bedroom. "Look at the names we give them," said Wayne. "It's no longer Rin Tin Tin. It's Eddie, like the dog on Frasier. It's people names."

On Anna Belle's first day of cancer treatment, Wayne handed the miniature pinscher to radiation therapist Anne Twedt and said, "Be brave."

With that, he was left in the waiting room with all the other owners. There was a retired couple from Spring Hill whose 12-year-old schnauzer mix had a tumor the size of a tangerine on his front leg. A woman from Orlando with a poodle. A Dunedin couple with a black Lab.

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After receiving her anesthesia, Anna Belle lies on the table of the radiation machine at the Florida Veterinary Specialists and Cancer Treatment Center in Tampa.
Near the tropical fish tank sat St. Petersburg lawyer Jaime Eagan, whose tail-wagging golden retriever, Anni, had a mast cell on her side. Last year Eagan lost her other golden retriever, Molson, to cancer.

"It was hard for me," the former prosecutor said, "so excruciatingly hard."

Inside the vets' offices, Twedt carried Anna Belle to the prep area and placed her on the towel-covered metal table. The animal's front legs were shaved from the knee down to prepare her for an injection of Propofol, a fast-acting anesthetic.

Anna Belle snarled at the injection, looking straight into the eyes of the person giving it to her, Twedt.

"There you go," said the therapist. "Everything is going to be fine."

Within minutes, Anna Belle's dark body fell limp on the towel.

Twedt gently pulled out the dog's tongue to prevent her from swallowing it when she came out of anesthesia. A plastic tube was placed down her throat. To check her heart rate and oxygen level, a monitor was clamped on her tongue.

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Radiation therapist Anne Twedt carries Anna Belle to get Wayne Kauffman’s assistance as the miniature pinscher comes out of the anesthetic.
After Anna Belle's paw was X-rayed, she was wheeled into the radiation room, through a heavy green door marked "Hazard."

The room is about the size of a small bedroom. Counters line the wall. In the center stands the linear accelerator radiation machine, which looks like an oversized microscope.

Anna Belle was laid, belly down, on a glass table. Her head was propped up with an empty plastic gauze container. Her cancerous paw was extended and the toes -- no bigger than watermelon seeds -- were splayed out with surgical tape.

Afterwards, she was groggy coming off the anesthetic. She let out a cough and slowly lifted her head from the beach towel. She looked around with dreamy eyes. Then Anna Belle was taken into the waiting room, where Wayne was experiencing what he called "the longest hour."

Every morning after that, Wayne dropped off Anna Belle at the vets' office and picked her up at the end of the day. He drove with the dog on a pillow in his lap. He didn't use the turn signal because she knew the sound meant a turn was coming up and turns freaked her out.

* * *

The Kauffmans are unable to have children of their own. They tried to adopt, but it didn't work out.

"We were very upset, both of us were," said Wayne. Into their lives came Ernie, the Labrador, who "did a whole lot more than he knows. He took everything away and really opened us up to living again."

A few years later, the couple added a girl, Anna Belle.

Do the Kauffmans dress up their dogs? Yes, they do. On Halloween, Kristy sewed a pink tutu and dressed Anna Belle as a ballerina.

But the Kauffmans are also the kind of pet owners who believe humans have a responsibility to animals. When they first got Anna Belle, she was highly aggressive. Many people told them to give her up. Instead, Kristy went with Anna Belle to a specialized canine training school -- three times a week for ten months.

* * *

Born on the farm, veterinary medicine has made extraordinary advances in the care of household pets. Today, there is ultrasound for dogs, arthritis medication for cats. And there are state-of-the-art facilities such as Florida Veterinary Specialists, which looks like a hospital for humans with its lobby, nurses' station and cancer ward.

"If we can do something to help a patient live a longer and better quality of life, then that's what we are here for as doctors," said Gary Oswald of Tampa Bay Veterinary Specialists in Largo, which has offered chemotherapy since 1990.

In the past, vets treated cancer -- if they detected it at all -- through surgery. But tumors often grew back or spread to other parts of the body, doctors found, so they tried chemotherapy, using anti-cancer drugs identical to the ones used in humans.

Radiation, introduced in the 1970s, was found to be effective in treating localized tumors like Anna Belle's.

"I felt death didn't have to be the only option for a pet with cancer," said Colorado State University researcher Ed Gillette, 68, who pioneered its use.

Gillette and his research team used a second-hand human radiation machine to treat tumors in dogs. The research was funded by the National Cancer Institute and the American Cancer Society, both of which were interested in the human benefits of Gillette's research. But he knew it would benefit cats and dogs, too.

At first, radiation therapy was offered at big veterinary schools such as Colorado State and North Carolina State University. Soon, pharmaceutical companies started funding research, and cancer care moved into the private sector.

On a cellular level, cancer is cancer -- whether it is in an animal or human. But there are some differences. For one, animals rarely experience hair loss.

Another difference is that animals don't understand what the vet is doing to them and why, said Andrea Kline, a spokeswoman for People for the Ethical Treatment of Animals, headquartered in Virginia.

The organization does not have a policy on cancer treatment for animals, said Kline. "We ask pet owners when making the decision to look into their own hearts and ask, "How much is this for my own self? And how much is it for the needs of the animal?' "

* * *

Belle breezed through the first week of treatment. She climbed into Wayne's Buick as soon as he grabbed the car keys. Once skittish, she allowed the vet technicians to touch her.

But at the end of the second week, she began limping because of the pain in her paw. At night, she kept moving and moving and moving and wouldn't sleep. "So we were up, too," said Kristy.

Kristy and Wayne knew the dog was really hurting when the whining started. Anna Belle was not a whiny dog. She didn't whine when she ate the ant trap and had to go to poison control. Nor did she whine when she got into the termite pesticide.

"It's killing us," said Wayne. "I'm feeling bad just to let her limp. And I'm thinking, two weeks ago, that wasn't happening."

"I wish she could talk to us," said Kristy.

After three weeks of radiation, the dark pads on the underside of Anna Belle's paws had become blistered and were slowly starting to fall off. This is a typical side effect from the radiation. The vet wrapped her paw in a wet cast, changing it three times a week for two weeks.

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Wayne Kauffman drives Anna Belle to the vet, gently holding the paw that is receiving the radiation treatments.
Each time they changed it, the vet technicians dipped the paw in cleaning solution. They picked off the peeling pads and coated what was left in a thick white cream, the same cream used on human burn victims.

The paw was wrapped in gauze, and Anna Belle was sent home with antibiotic capsules, which Kristy fed to her in meatballs. The dog also received a morphine patch, another human product.

Patch on back, cast on foot, Anna Belle had a hard time sleeping. Kristy came home for lunch, just to be with her. She laid her little dog on her chest and stroked her again and again until, finally, Anna Belle fell asleep.

Each time the wet cast was changed, Wayne sat in the waiting room. One day, he asked to be present when it was unwrapped. "I wanted to see what was causing the whining," said Wayne.

He walked into the prep area apprehensively. Anna Belle lay on a table. She had a mask over her snout; this was the first time Wayne had seen Anna Belle under anesthesia.

Then, he saw the paw.

From the knee down, the hair had been shaved away. The skin was red and pink. The pads were nearly all gone. Exposed, the paw looked like an open wound.

"It hurt me," said Wayne. "How could I subject her to that? I understand that the pain is short lived and the rest of her life, she'll be fine. But I don't like to see her hurt."

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Kristy Kauffman lets Anna Belle and Labrador retriever Ernie takes their toys to the porch of their New Port Richey home during some quality play time after Anna Belle’s treatments are done and her paw has healed.
The wet cast came off for good in mid May. The hair hadn't grown back. The skin was still raw pink, but there was the gray of new skin growth. The paw was soft, as any wound is when the bandage is first removed. Now the paw had to air dry to develop toughness again.

To prevent Anna Belle from licking her paw, she was given a cone-shaped plastic sheath to wear around her neck. A "party hat," Twedt called it. Remember the tutu? It's like the tutu, except it's worn around the neck, she said.

In the following weeks, Anna Belle applied more and more pressure to her paw and was slowly returning to her routine, playing with her squeaky banana, dragging her cushioned sleeper around the Florida room, following the sunshine.

The pads hardened; the gray turned black. The pink skin turned brown. And the hair started to grow back -- mostly white, though, because radiation destroys pigment in hair follicles.

Anna Belle will have one white paw, but at least she will have her paw, so the treatment was worth it, said Wayne. After her last checkup at the doctor's office, he pulled his white Buick into the drive-through and treated her to McDonald's french fries.

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