Goldendoodle survives rare tumor after treatment by UF veterinarians

Cello and family
Cello, far right, is shown with other members of his pet family in this image provided by his owner, Joan Garbutt.

A 12-year-old female goldendoodle named Cello, who had a rare tumor so aggressive that it caused a life-threatening obstruction of major veins, is home in St. Petersburg recovering from surgery at the University of Florida College of Veterinary Medicine after being given only weeks to live without intervention.

The successful outcome was the result of veterinarians from many specialties at UF working together to manage the unusual case — and not giving up, said Elizabeth Maxwell, D.V.M., a clinical assistant professor in surgical oncology at UF and part of the team who treated Cello in May and has followed her throughout her recuperation.

“This was one of the most advanced cases of tumor invasion that any of us had seen, and there was a very high chance that Cello could have died during surgery,” Maxwell said. “However, without surgery, she would have certainly died in a couple of weeks. With the combined efforts of all the specialists — critical care, internal medicine, radiology, anesthesia and surgical oncology — we were able to successfully remove the tumor and hopefully give Cello a long and happy life.”

Cello’s owner, Joan Garbutt, first noticed something was wrong with her dog while giving her a bath. One of Cello’s back legs was swollen in the knee area, and Garbutt sent a picture to her veterinarian, Brett Zielinski, D.V.M., who saw Cello that day. When Cello’s leg did not improve after a few days of antibiotic therapy, an ultrasound revealed a thrombosis, or blood clot. Zielinski recommended that Garbutt take her to UF.

“I drove her to the E.R. in Gainesville that night,” said Garbutt, a retired Air Force colonel who adopted Cello as an 8-week-old puppy on St. Patrick’s Day while on military leave.

A CT scan soon revealed a very large tumor of the adrenal gland that was massively invading the largest vessel in Cello’s abdomen, blocking most of the blood flow from hind limbs and abdomen to the heart. She was diagnosed with a pheochromocytoma, a tumor of the adrenal gland that often causes episodes of cardiac arrhythmias, high blood pressure, fainting episodes, weakness, blindness and sudden death.
Kaitlyn Mazzaccari, D.V.M., a resident with UF’s emergency and critical care service, was on duty that night.

UF surgical oncology team
Members of Cello’s surgery team following her procedure: Dr. Michael Blumenthal, Dr. Elizabeth Maxwell, Dr. Judit Bertran, Dr. Deborah Rohner, Dr. Carlos Souza and Dr. Jose Carvahal, holding Dr. Bertran’s dog (not Cello), the team’s “mascot”.

“She broke things down for me to process and understand, allowed me to be emotional at times, and always answered all my questions,” Garbutt said. “Dr. Mazzaccari consulted with the oncology team and recommended that I talk to them, as they thought there was a chance of saving Cello.”

Maxwell then called Garbutt to discuss the team’s recommendation of surgically removing the tumor and what that would involve: Removal of the right adrenal gland with the associated tumor, removal of the right kidney and cutting open the caudal vena cava, or major abdominal vein, to remove the tumor that was obstructing blood flow.

The procedure had several potential complications, Maxwell explained: Severe life-threatening hemorrhage, cardiac arrhythmias, dramatic fluctuations in blood pressure, kidney injury and potentially fatal blood clots.

“Mortality rates are as high as 50%,” Maxwell said.

After weighing the options, Garbutt decided to move forward with surgery.

“Dr. Maxwell said that Cello could live another two to four years if surgery was successful,” Garbutt said. “So, I agreed.”

In preparation for surgery, the UF team sent Cello home with Garbutt on medications to help prevent some of the known complications.

“It was a very long week at home,” Garbutt said. “Cello was very worn out and sick, and at one point I did not think she would make it through Mother’s Day.”

The lead surgeon who would perform Cello’s surgery, Carlos Souza, D.V.M., an assistant professor of surgical oncology, contacted Garbutt to walk her through the exact surgery the team would perform.

“He gave me a 50% success rate of her making it through the surgery,” Garbutt said. “I dropped her off on that Friday morning with a heavy heart and tears in my eyes, wondering if this was our last goodbye.”
Garbutt added that underlying her emotional state was the reality of COVID-19.

“All of our interaction was by phone,” she said. “I turned my baby over to a surgical team I had never looked in the eye to build trust. It was exceedingly hard. I can’t even describe it.”

Souza promised Garbutt he would call her when Cello had undergone anesthesia and asked her to remain close to her phone in case he had to make some tough decisions.

“It is funny how a day at the office can fly by but waiting for a loved one to come out of surgery is like a lifetime,” Garbutt said.

Five hours after the complex procedure began, Souza called Garbutt to say Cello had come through surgery, but the next few days were going to be very difficult; Cello was not eating and was lethargic. Her kidney values were rising, and the doctors were concerned.

“We talked about me visiting her and if that might help,” Garbutt said. “My brother and sister-in-law live in Gainesville, so I was blessed and welcomed to camp out on ‘Operation Save Cello.’”

Twice a day for about a week, Garbutt would visit Cello while she continued to recuperate at UF.
Eventually, Cello’s kidney functions began to improve. She was put on a feeding tube, and her legs began to swell due to a lack of protein. Veterinarians treated Cello in a hyperbaric chamber to try to reduce the swelling and sent her home with Garbutt a few days later.

Cello continued to need medication every couple of hours and was still not eating. Only when Garbutt’s home veterinarian recommended a specific type of food did Cello’s appetite improve.

Slowly, over weeks, then months, Cello continued to recover. When she came for her last check-up at UF in early August, tests revealed no blood clots at all, and no cancer.

“She is doing great, free of clinical signs and all medications have been discontinued,” Souza said. “The swelling on her legs is completely gone, and she is now a completely normal and happy dog.”

Garbutt said she felt the UF team had performed a miracle.

“Cello has been there through my hardest days of service with a toy in her mouth and a snuggle,” she said. “Thank you is not enough.”