A Plea for Help

* * * Updated September 2013 * * * 

Dear Adopters, Supporters, Friends, and Families of ISDF:

A short while ago, we were devastated to learn that dear Mona, recently adopted, was not suffering from a urinary tract infection or a post-surgical spay complication as we had originally thought, but from a disorder known as TVT - transmissible venereal tumor.

Once we had recovered from our initial shock, our thoughts turned first to her family - we are thinking of them constantly and are so filled with concern. And then to practical matters - how is Mona doing? What are the basics of the disorder, and what is her prognosis? Will Lucy, her sibling, be affected? Why did this happen, and how is TVT contracted? What has been done for Mona already, what still needs to be done, and how much will it cost her new family? 

So...this is a two-pronged post.

One, it is a central place to disseminate information about TVT to our adopters, and to hopefully address any fears or concerns they may have about their own adoptees.

Two, it is an urgent appeal to our ISDF supporters and friends. Mona's family needs our help desperately. Thank you for taking the time to read this, and for considering helping her through this financial crisis.

The good news.

Let's start there.

With proper treatment, the prognosis for full remission of TVT is excellent. Mona should make a complete recovery. A more detailed description of the disorder can be found below, but this is the single most important piece of information we want to convey. We are so relieved for this sweet little survivor, though we are heartbroken for all of the emotional fallout her family has had to deal with these past few weeks.

The bad news.

The cost of Mona's care.

All told, her family has paid out approximately $3500 so far and her estimated total care costs are projected at close to or slightly above $5,000: for her care prior to the diagnosis; for the diagnostics and biopsies that confirmed what we were dealing with; for the surgical removal of an internal tumor; and for her targeted chemotherapy treatments. Mona's family adores her and do not question the care of her cost - however, they understandably never expected to be saddled with such staggering expenses in the first few months of her life with them.

ISDF would like to reimburse them for as much of these costs as we possibly can; however, as most of you will understand, a full reimburse out of our pockets at this time will effectively limit our ability to assist any further dogs this calendar year and possibly beyond, other than the two Malaysian street dogs and little Sissi, whom we are already committed to helping at this time.

Hence, this urgent plea for help.

We are fervently wishing that our ISDF friends, families, and supporters will each consider giving $5 or $10 towards Mona's medical reimbursement. Of course, and as always - we pride ourselves on transparency, and our plan is to post a financial update here and on our Facebook page as to what we were able to raise, what it was used for exactly, and how much the shortfall was, once all is said and done. 

Every dollar raised will offset our out-of-pocket costs and enable us to continue doing what we are doing. The alternative is very sad for us to consider right now - but if we are to be realistic and practical, we must acknowledge that this crisis may be the one to bring our humble and small (but mighty, we'd like to think) organization to its knees.

TVT 101.

As Dawn and I often say, we are walking a path with a steep learning curve. She had never heard of TVT prior to Mona's diagnosis, and I had vague associations of it mostly being an issue for hoarders with large amounts of unsterilized dogs in the southern United States.

Over the past few years, I have seen perhaps five photos of Thai dogs with exterior genital tumors, though I mostly mistook them for rectal prolapses at the time, as captions were usually in Thai or didn't mention TVT specifically if in English.

It was never discussed as being a common occurrence in conversations with our many Thai dog adoption associates across the world, and our hope is that this is because it is truly not nearly as prevalent as it could be, given the circumstances. Additionally, Dawn has a policy that upon each dog's arrival at O'Hare, she immediately proceeds to our wonderful vet for a complete physical exam, paid for by Dawn out of her own pocket, primarily so that she can hand over our new arrivals with complete confidence in their good health. Of course, the exam does not include an internal genital exam as we never had cause to feel this was necessary - so we will be reviewing and amending our protocol for the future, based on the recommendations of our professionals, given this recent occurrence.

To compound matters, as this whole situation began to develop, the vet who spayed Mona was brought into the conversation and Dawn, myself, Mona's pet parents, and Patarin were all startled to discover that besides a cyst on Mona's hip, she had had cysts removed from her ovaries at the time of her Caesarean section/spay surgery. Had we known this, the diagnosis of TVT might have been made some time ago, saving lots of time, effort, anxiety, and veterinary costs. This is not meant to point a finger of blame at anyone, as Mona's surgery clearly occurred under dire circumstances, and information was simply lost in the shuffle. She was rushed from Khemmarat livestock center to Bangkok on a transport during which time, as I understand it, she was literally going into a traumatic labor situation as she traveled. She arrived in rather a bad state, and Patarin's experienced and very excellent veterinarian was able to perform emergency surgery on her (a combination c-section/spay), saving her life, as well as safely delivering her six puppies, who required immediate medical attention due to their harrowing arrival. Sadly, only four of her babies ultimately survived, despite the best loving care of Patarin's vet team and Pat herself. Additionally, at the time of her spay, Mona was still a "Magic 10 dog" and not yet officially an ISDF candidate, so I don't believe we received her original surgical papers or reports. We of course understand completely that the information about the ovarian cysts was overlooked given the circumstances, and are only saddened to think that had we known about the possibility of TVT before her arrival, it is very possible that none of this fundraising would even be necessary right now.

So - for the reasons stated above - unfortunately, this disorder was never even on our radar prior to Mona's recent diagnosis. And amidst our sadness at her condition and the worries it has caused her lovely new family, perhaps this will be the one bright spot - that we are hopefully able to harness this newfound knowledge, learn all we can moving forward, and prevent this scenario from ever unfolding again.

There are some excellent resources for information on the web, but many of them are technical or research articles, so here - for our adopters and supporters - is a "crash course" to bring everyone up to speed:

What is it? 

TVT is a common tumor, only found in dogs. It has a patchy worldwide distribution including parts of the Caribbean, USA, Southern Europe, Asia, and Africa. It is transmitted by direct physical contact and occurs in both sexes.

How do dogs contract it? 

Imagine a tumor that can be transmitted by touch. For dogs, this is not a matter of imagination; the Transmissible Venereal Tumor (TVT) has been described since 1876 and is commonly found on both male and female dogs. 

Transmission is by simple physical contact between an existing tumor on one dog and abraded skin on another. It is most commonly spread during mating. 

TVT may be visible as an external fleshy growth on the penis or vulva, or may simply present as genital bleeding (eventually the tumor will become eroded on the surface and bleed). 

Strangely, the tumor cells are not the patient’s own cells transformed into cancer cells - this is actually a very primitive type of tumor that grafts itself from one dog's body onto another dog's body. Developing TVT is somewhat analogous to getting bitten by a mosquito, and having the few mosquito cells left behind actually trying to grow a new mosquito on one’s body.

What symptoms are present?

TVT tumors grow rapidly at first, then remain static for a time as the dog's immune system produces specific antibodies that cause the tumor to spontaneously regress. Once the tumor regresses, the dog is highly resistant to further tumors and TVT is very unlikely to recur down the road, even after additional exposures.

How is TVT confirmed?

Diagnosis is made either by biopsy (taking a small piece of tumor tissue for analysis) or by cytology (obtaining a smear of the tumor’s cells and looking at it under a microscope as shown above).

How is it cured?

Treatment of TVT is straightforward and generally very rewarding. Surgery alone often leads to recurrence, and surgery may sometimes be difficult due to the location of these tumors. Chemotherapy is very effective - the prognosis for complete remission with chemotherapeutic drugs delivered intravenously is excellent.

What risks does TVT pose to humans and other pets?

This is the obviously the most frightening aspect for our adopters. We are happy to note that tumors cannot be transmitted from dogs to humans or other species. However, as stated above, it can be transmitted from dog to dog. 

We were devastated to learn this, as Mona joined a household of three - Mom, Dad, and beagle-mix sister, Lucy. We empathize deeply with her family, understand how upsetting it is that they were placed in this situation, and are deeply aggrieved for the concerns we have inadvertently caused this wonderful family. We are so very sorry! Our hearts are broken - we had the very best of intentions to help save dear Mona, and are so grateful to the Jones-Santana family for their commitment to our sweet little survivor and for allowing us to learn and grow from their difficult experiences.

We are asking for prayers, well wishes, and all good thoughts from our ISDF family to go out to Mona's lovely family for her complete recovery and Lucy's continuing good health.

Our hope is - and we were quickly reassured to learn that - there are several of factors on our side in this regard. The majority of TVT tumors present outside the body, hence why it is often noticed quickly and treated before adoption of an animal takes place. In Mona's case, the tumor was located internally, which should strongly reduce the risk of transmission, as it generally requires another pet coming in direct contact with the actual tumor - either through sexual contact, or because the resident pet has been allowed to extensively lick or otherwise have direct contact with an exterior tumor itself. Hopefully, Mona's having an interior tumor alone will reduce the risk of transmission to her sister. 

Although there have been cases of dogs with shared water bowls and dogs who groom one another passing the disease without sexual contact, we were greatly relieved to have our ISDF vet (who has worked extensively with street dogs in the West Indies where TVT is common) confirm that such forms of transmission are highly uncommon. We remain aware that there is still a risk, and are extremely concerned about this possibility, but for now, continue to hope and pray the risk can be minimized now that Mona's diagnosis is known, she has had corrective surgery, and she is beginning the final stages of treatment with chemotherapy at this time.

All of our adopted dogs are sterilized prior to entering households, and are placed only with other sterilized dogs. Given that Mona lives with a single, spayed female, and that her tumor was internal (and has since been removed), we are keeping our fingers, toes, and ears crossed that Lucy will remain TVT-free. 

Please join us in these prayers and hopes.

* * * * *

As far as how Mona is doing now - her family described her treatment to date in their own words. An excerpt here:

"We wanted to go ahead and send along another update about Mona. She had her surgery [to remove an internal growth caused by TVT] two weeks ago and has been recovering really well - she had her staples taken out today and can start getting back to normal activity in a few more weeks. She's been a total champ while recovering- our biggest challenge has been keeping her calm so she can recover.

We're still working to figure out what's going on with her tumors but are almost positive it's TVT - we're waiting on one more test result to confirm. They did find another cyst on the ovary they removed during surgery but it was benign. As of now the tumors are just in her vagina and once we have it confirmed we can start chemotherapy immediately to cure it.

We want to move forward with chemo treatments with the vet we're currently using - they've done extensive testing and really understand her medical history more fully than anyone else at this point - but know it's going to be really costly. We've already spent upwards of $3500 trying to resolve her health issues and know that chemo is not going to be cheap.

The good news is a few months from now Mona should have a clean bill of health."

* * * * *

Dawn and I spoke at length on the phone last night, and have plans for another phone conference this weekend. She will be calling concerned adopters to explain the above individually, but hopefully all of our ISDF supporters and families will have a chance to read this to help address their concerns as well. 

Anyone with any questions, concerns, or comments should - of course and as always - feel free to reach Dawn directly by phone at 414-426-4148 or by email at trimmel@usa.net. My phone is 847-912-3212 and my email is zoomdog500@comcast.net should you need to reach one us immediately. 

We appreciate all input as we make our way down this steep path of a learning curve, striving to continually increase our knowledge base and better this foundation.

We are heartbroken for the worries and fears we have unintentionally caused Mona and her lovely parents, Nate and Kelly, in regards to both Mona and sweet Lucy. 

Our deepest apologies to all of our adopters, as well, as we are besides ourselves imagining the worry that others may be feeling as well. Hopefully this post will in some small way help to assuage any anxieties or fears. 

We are hoping against hope that we can harness the power of our kind supporters and friends to help Mona's family move through this crisis without crippling the foundation's finances in the process.

Dawn and I are in firm agreement that we must place a moratorium on all adoption efforts at this time, beyond the few we are already committed to, until this issue is firmly and satisfactorily (to all parties concerned) behind us. 

But we are hoping and praying that Mona will soon be on the road to healing, that all of our other dogs and sibling dogs will continue in good health, and that the foundation can continue its work in the near future of doing what we are so passionate about. 

Any help whatsoever for Mona's family towards her veterinary care is welcomed with open arms - every penny truly counts, at this point. Please visit our website at www.istreetdog.com and earmark your donation towards Mona's medical fund.
Also, please note that we are holding a rummage sale (the link takes you to photos of the event) in Burr Ridge on October 5th & 6th from 9 a.m. to 4 p.m to raise funds for Mona. Please come and have a "rummage" for some good deals - plus check out our baked goods for humans & doggies alike, browse our informational brochures, and suss out our cool new gear (t-shirts, bandanas, stickers...the list goes on) - AND visit Megan, Saalim, Sparkle & other ISDF rescue doggies while you "shop for Mona".



We are so very grateful to all of you in advance. Thank you for taking the time to read this, and for considering helping dear Mona. 

With deepest apologies and sincere gratitude to all of you for your dedication and support,

Dawn & Izumi