Reema's Osteosarcoma Treatment
ABOUT REEMA
For those who have not yet been fortunate enough to meet Reema, she is a nine year old bullmastiff and former rescue animal. Adopted at six months by her owner, Kyle Ruggieri, she has touched the lives of her many roommates and their friends over the better part of the past decade. Reema is a dog of exceedingly sweet and loving temperament, always preferring cuddles to roughhousing.
HER SITUATION
Turning nine on December 19, Reema has always had the energy of a dog several years her junior. Running through the Blue Hills or White Mountains or just through the streets of Brighton, Reema loves to be active throughout all seasons. 
When she began limping one day in early February, it was not cause for any immediate concern; Reema is famous for stretching out in such a way as to cause her legs to fall asleep. However, when her condition did not improve a few days later, we knew something was unusual about the situation.
After a few rounds of testing, Reema was diagnosed with osteosarcoma in her right shoulder; in other words, bone cancer.
But there is good news! She is still in great spirits, wagging her tail and demanding pets, complete with flopping over to expose her belly for rubs. She continues to eat (and beg for treats), sleeps, and gets impatient when we don't let her outside quickly enough. Overall, she is still very much Reema!
Unfortunately, her right leg is almost totally lame at this point, and is a source of constant discomfort for her. Walks are not really an option right now, which is frustrating for all of us because she wants to go; she just can't do it.
WHAT THIS DIAGNOSIS MEANS
The diagnosing veterinarian referred us to New England Veterinary Oncology Group in Waltham, MA. Reviewing her records, the NEVOG offered three paths of treatment:
1. Take no further action, but attempt to manage her pain and keep her comfortable. Because the cancer is in her leg, she will continue to deteriorate, but the discomfort and pain will increase until her personality becomes impacted. At that point, her quality of life will be next to nothing, and we will not allow Reema to suffer needlessly. This downward sloping path would come to an abrupt end after 2-4 months, much of it spent in pain.
2. Pain management therapy through NEVOG, including palliative radiation therapy and oral/intravenous medications. Osteosarcoma causes pain because of invasion and destruction of normal, healthy bone. This path would attempt to slow the death of the bone and provide Reema with the most comfort for the duration of her life. However, the cancer, located in her shoulder and leg, will remain in her body, and as the bone continues to die, will cause her increasing pain and discomfort until she inevitably succumbs. This option has the potential to offer Reema several months of quality life, though survival beyond 4-6 months is unlikely.
3. The final treatment option is a combination of leg amputation and chemotherapy.
Our first reaction to this course of treatment was one of horror. Amputation? Chemo? We love Reema as a member of the family; if she only has so much time left, why would we put her through that kind of agony for our own selfish purposes, to gain another few months with her?
The vets at NEVOG anticipated this reaction, and before we could fully object, addressed both issues.
Osteosarcoma of the shoulder is a common diagnosis for dogs. In cases where the cancer is confined to the shoulder and leg - as is the case for Reema - the source of pain is entirely within the limb. Once that limb is removed, the pain relief for the dogs is tremendous. Most feel so much better within 24-48 hours that their vet and owner have to fight to keep them calm as to avoid additional injury. Though we were skeptical, our own conversations with other NEVOG patients, as well as some internet research, left us confident that a three-legged Reema will be nearly as capable of walking, running, jumping, and otherwise playing as the four-legged version.
Furthermore, the fact is that she is essentially an amputee already; her leg is causing her serious pain and cannot support any weight. The muscle on the leg has begun to waste away; soon it will be literal dead weight.
As for the chemo, the negative connotations associated with humans enduring chemotherapy do not hold true for animals. Unlike when this treatment is administered in humans, the goal is not a complete cure, but rather to prolong the dog's quality of life. The horrible side effects generally do not occur in dogs, and the amount and frequency of the chemo treatments is far fewer than in humans. In total, Reema would probably have to undergo 4-6 rounds of treatment, each lasting about 30 minutes.
NEVOG was very reassuring that this third path would offer Reema the greatest quality of life, which is the most important thing to everyone. And by quality of life, we mean having Reema be able to do all of the same activities she enjoyed only a few weeks ago; we have no intention of keeping Reema alive but lame and immobile, in constant pain.
On average, dogs who undergo this treatment survive at least 12 months, with 20% still alive after 2 years. If you've met Reema, do you have any doubts that she's not in the 20%?
OUR PLAN FOR HER TREATMENT
Because the third path to treatment has the dual bonus of providing Reema with the highest quality of life while also keeping her alive for the longest possible amount of time, that is the course we are going to take. Though there are no such things as good options at this point, this is the choice we have made.
The amputation is yet to be scheduled, but will be done ASAP. She will begin chemotherapy three weeks following the completion of surgery.
WHAT WE ARE ASKING FOR
We are seeking contributions to offset the costs of Reema's medical treatment at NEVOG, and any referring facilities.
Because so many people know and care for Reema, we thought they might want to participate in her fight to return to the functional and goofy dog that she has been throughout her life.
The cost of her treatment will not be cheap, as it includes x-rays and other scans, radiographs, medication, anesthesia, general examinations, chemotherapy, and the surgical amputation itself and related recovery.
Regardless of the success of this campaign, Reema is going to receive the best possible treatment. The amount of funding received will not impact her quality of care.
OUR PLEDGES TO YOU
For those considering donating, there are a few points we want to make absolutely clear:
1. We (and the staff at NEVOG) have the best interests of Reema in mind at all times. "Quality of Life" is the mantra that guides every one of our decisions. We love Reema like a member of the family, and will never allow her to suffer needlessly. When the time comes to say goodbye, we will not hesitate to do so; but her spirit is still very much alive.
2. Regardless of the dollar amount received (if any), we are going to get Reema the best possible care, expense be damned. This campaign is merely to offset costs that we are already committed to absorbing.
3. Any funds received will go exclusively to paying medical expenses incurred at NEVOG or any referring facilities. The funds will not be put towards food, toys, or any other general care.
4. If, after the end of our and Reema's relationship with NEVOG, there are funds remaining, they will be returned to donors on a proportional basis.
THANK YOU FOR YOUR CONSIDERATION
Thank you for taking the time to read about Reema and her situation. If you have any questions or concerns, please do not hesitate to contact us. We are striving for absolute transparency, so we'll be happy to provide as much information as anyone desires.
And, finally... come visit Reema! She loves to see friends! It brightens her spirits immeasurably, and seeing her smile brightens ours in turn.