VHC’s Medical Oncology Team Gives Service Dog a Second Chance

In 2008, the Fiorelli family of Columbia, Illinois, made a trip to China to adopt a 1-year-old girl into their family. Their daughter, whom they named Natalie, was abandoned on the doorstep of a hospital as a baby and left as an orphan. When they decided to adopt, they knew they wanted to adopt a child with special needs, and they sought options to do so. Before they made the trip to China, parents Julie and Bernie Fiorelli received information that Natalie had a heart condition and pneumonia. Upon their arrival at the orphanage, it was clear that she was dealing with a different condition. When they returned to the United States with their new baby, they took her to doctors to uncover the issue and discovered that Natalie had been poisoned with carbon monoxide. The poisoning resulted in damage to the interior of Natalie’s brain and was classified as cerebral palsy. This was quite different from most cases of cerebral palsy, which normally affects the outer portions of the brain, and the doctors considered it a miracle that Natalie had survived. “The doctors were baffled and said she shouldn’t be alive,” said Julie Fiorelli.

Now 13, Natalie has made incredible progress. She is unable to speak and has some issues with fine motor skills, but she can use a keyboard and communication device to communicate with her friends and family, as well as drive a power wheelchair. “She’s just a normal kid with normal friends who gets in trouble a lot for being too sassy,” said Julie Fiorelli. “You get through life and you start getting used to stuff, so I just have to remind myself that she’s amazing.”

Because of his experiences with Natalie, her older brother, Mitch Batschelett, has begun pursuing neurology/neurosurgery at Rhodes College in Memphis.

Along the way, Natalie has had the help of service dogs to help her progress. Her current helper is a 2-year-old golden retriever named Brady, ─ named for NFL quarterback and Natalie’s favorite football player, Tom Brady. Brady helps Natalie in a variety of ways, such as helping her keep her balance when she is standing, running to her for emotional support when she is upset and even alerting her parents when she is in need.

Brady is the Fiorellis second golden retriever and service dog. Their first service dog, Bentley, passed away only 36 hours after he was diagnosed with cancer at age 5. The Fiorellis, especially Natalie, were devastated. In the wake of this, the family was contacted by multiple organizations who heard about their story and offered the opportunity of in-home training if they wanted to adopt a puppy. The Fiorellis then found a breeder and their current dog Brady when he was 4 weeks old. For nearly Brady’s whole life, he has been at Natalie’s side.

Unfortunately, Brady was also recently diagnosed with cancer by his veterinarian after the family noticed he was sleeping more and had a lump in his side. Based on the recommendation of their veterinarian, they came to the University of Missouri Veterinary Health Center for their next steps.

Owen Skinner, BVSc, DECVS, DACVS-SA, MRCVS, an assistant professor of small animal surgical oncology, and Jason Couto, DVM, MS, a medical oncology resident, were tasked with finding the best way possible to deal with Brady’s condition. “When he first came in, we didn’t know exactly what was going on with the mass in his side,” said Skinner. “The medical oncology team got things started with a CT scan, and discovered that the tumor was actually more within his chest rather than outside of his chest.”

A biopsy with the medical oncology team was suggestive of chondrosarcoma, a cartilage tumor, although the tumor did look unusual and osteosarcoma couldn’t be ruled out.

Julie Fiorelli said once they realized surgery was an option, there was no doubt that they were going to do everything they could for Brady. “We were sitting in the CVM, and they were telling us how much it would cost,” said Julie. “My husband said there wasn’t any question. We decided we were going to go through with it.”

The VHC clinicians planned the surgery, which was a chest wall resection. The surgery was planned to allow removal of the mass with wide margins. This required taking not just the mass but part of five of Brady’s ribs. During surgery, the mass was also, unusually, found to be stuck to Brady’s right lung and the pericardium, a sac that surrounds the heart. Part of Brady’s lung and pericardium were resected to allow the tumor to be removed while minimizing the risk of leaving disease behind at the surgery site. Brady’s mass appeared to have been completely removed when examined by a pathologist. Unfortunately, it was determined that the tumor was osteosarcoma, a tumor of bone, which is more aggressive than chondrosarcoma.

After surgery, both the Fiorellis and Skinner say Brady is doing well. Julie Fiorelli says rather than being sluggish, he has been running around and constantly ringing his bell, which he uses to ask to go outdoors. Brady did have some discolored urine for a short time after his surgery, but that issue has since resolved itself.

Brady is now going through chemotherapy and recently revisited the VHC. He had restaging chest radiographs, which didn’t reveal any sign of metastasis to his lungs, the main concern with osteosarcoma.

Though he is not out of the woods just yet, Julie Fiorelli says the family is just happy to still have Natalie’s helper around. “The point is that Brady is himself right now, and Natalie is just as happy as can be,” she said. “She has happy times now. It was so tragic with Bentley. It’s less of a shock and we are giving Brady every opportunity to fight for everything he could and be happy at the same time.”

By Nick Childress