Lymphoma Treatment at NC State Grants More ‘Wonderful Life’ to Zuzu

“Every time a bell rings, an angel gets its wings,” towheaded tyke Zuzu Bailey declares in the 1946 Christmas classic “It’s a Wonderful Life,” charming her on-screen father and generations of audiences.

And every time the Krebs family hears the collar of their 7-year-old Lab mix, Zuzu, jingle as she joyfully fetches a Frisbee, they can’t help but feel that their family has been touched by a small miracle, too.

Zuzu, named for the movie character, was diagnosed with multicentric B-cell lymphoma, one of the most common types of cancer in dogs, just before Thanksgiving last year. Already balancing the financial strain of the holiday season and a looming tuition payment for their college-aged daughter, Garett and Trish Krebs worried over Zuzu’s well-being and the cost of her treatment as they ferried her between her appointments in Raleigh and their home in Wilmington.

Their fears were quickly assuaged at NC State, where top-notch oncologists guided Zuzu into remission within three months of chemotherapy treatments and connected the Krebs with funding from Petco Love and the Blue Buffalo Pet Cancer Treatment Fund that covered 75% of Zuzu’s treatment costs.

“We lucked out,” Trish Krebs says. “We felt so fortunate that the Petco funding was available to us. And NC State has just been great with Zuzu. She looks forward to seeing her vets, and she would have probably been long gone if it wasn’t for the treatment that she’s receiving there. It’s just been really, truly helpful.”

According to the Krebs family, Zuzu showed no signs of illness prior to her diagnosis and has remained as energetic as ever during her chemotherapy treatment.

The family’s primary veterinarian in Wilmington found that Zuzu’s lymph nodes were swollen during a routine physical exam last fall. She referred Zuzu to the NC State Veterinary Hospital, which offered the best treatment options for Zuzu’s quality of life.

Zuzu’s lymphoma was already at Stage 4a when she arrived at NC State in December, meaning that cancer had spread to all of her lymph nodes, liver and spleen, but she was still feeling well at the time of her diagnosis. While canine lymphoma can present a range of symptoms, it’s not uncommon for canine patients to appear healthy prior to advanced testing, says Dr. Kait Esson, a third-year medical oncology resident at NC State.

“B-cell lymphoma is a cancer of white blood cells that are normally found in the body that just start replicating out of control, and it’s the most common cancer we see in dogs at NC State,” says Esson, who has worked with Zuzu throughout her treatment. “Multicentric lymphoma is differentiated by the phenotype, which is a B-cell or a T-cell — those are just two of the different types of lymphocytes that are normally found in the body.”

Zuzu’s veterinarians recommended she undergo the CHOP protocol, a chemotherapy treatment that is also used in humans and named for its drug components: cyclophosphamide, an oral chemotherapy agent; hydroxydaunorubicin, an injectable chemotherapy treatment also known as doxorubicin; Oncovin, another injectable chemotherapy drug that is also called vincristine; and prednisone, an anti-inflammatory steroid given during the first few weeks of treatment.

CHOP tends to have the best patient outcomes of any treatment for canine multicentric lymphoma, Esson says. The treatment extends the lives of patients with B-cell lymphoma by another year, on average.

Oncologists aim for dogs receiving CHOP to go into remission within the first couple cycles of chemotherapy. That trend held true for Zuzu, whose lymph nodes returned to a normal size by early March. She completed the CHOP protocol that month.

“All during the treatment, she never slowed down,” says Garett Krebs. “If she had an off day, it was very infrequently, and it wasn’t really that bad. She stayed active. Frisbee is her favorite thing, and she never lost that during any of the treatments. She was constantly still in ‘play mode.’”

That’s what NC State’s oncologists aim for during treatment, Esson says: keeping pets happy, active and feeling so good they don’t even realize they’re sick. Zuzu continues to visit the Veterinary Hospital for monthly rechecks, and she’s still in remission as of August.

“When we go to NC State, Zuzu’s happy to meet with everybody there,” says Garett Krebs. “We get into the exam room and she runs to the back door into the clinic to put her nose against it, like she really wants to get back there. The vets were really super sweet with us and very attentive with any questions we had.”

“Zuzu likes to see her vet friends,” Trish Krebs adds.

In “It’s a Wonderful Life,” the main character George Bailey learns that the generosity he has shown others throughout his life returns to him tenfold in his time of need. The Krebs, and Zuzu’s care team, are grateful for Petco’s help when Zuzu needed it most.

“The support from Petco has honestly been amazing,” Esson says. “Being able to tell owners who aren’t sure if they’re going to be able to get the care they need for their pets, ‘Hey, we have some support for you,’ it really does make a huge difference in their lives.”

And in her own way, Zuzu is paying that generosity forward. Early in her treatment she participated in a clinical trial aiming to optimize dosage amounts for mustargen, a proven chemotherapy drug for lymphoma. Her participation will help future pups receiving the treatment.

As angel-in-disguise Clarence says to George Bailey, “Strange, isn’t it? Each man’s life touches so many other lives.”

Zuzu proves the same holds true for dogs.