October 27, 2010

It's Doggie Cancer, and It's Bad

I hate when medical people lead you off with what sounds like good news, and then lower the boom.

When I was a freshman in high school, an aunt of mine wound up in the hospital due to an accident, and while she was recovering we got a call asking us to get to the hospital ASAP. I remember standing in a stairwell of the hospital with my mother (apparently all the consult or "family" rooms were occupied) while a doctor rambled on and on and. on. about her various health problems.

It sounded bad, but like there was still hope. Finally, I couldn't stand the sound of his voice anymore, and I just cut in and said "So you mean she's still alive, right?" And then he said, "No, she's gone. She died about an hour ago."

Everything went black, and he reached out to catch me as I collapsed. To this day, I still don't understand why he kept rambling incessantly when she was already gone.

This afternoon was a little like that.

We got to the vet's office, and the front desk told us the doctor was preparing the instructions. One of the vet techs handed us a couple of bottles of pills. She sounded so perky and happy, not like she was telling someone horrible news.

One of the bottles was a steroid. The vet had said if it was the best case scenario, steroids would be what the dog needs.

There were instructions to give him the pills for 8 days and then call to let them know how he's doing. "If it was cancer, they wouldn't want a report on whether he's improving," I thought.

Hope crept in.

"For once, we're not landing on the rare side of the odds," I thought. "Thank God."

Ha. When the vet finally came into the room, she seemed perky for a few moments, too. Then she told us it's bad. Very bad.

He has a rare nerve sheath cancer. It's big, and it's spreading.

If it was just in his leg, she would recommend "taking off" (they use that term, as if it's just a piece of clothing) his leg without a doubt. She says it isn't the kind of cancer that recurs in multiple places, so that usually cures it. And he's a strong, mentally tough but very happy-go-lucky dog, so she thinks he wouldn't be fazed much by losing the leg. I agree with that assessment of him.

But. But.

The tumor has spread, and it's now involving a couple of roots along the spinal cord and it's touching the spinal cord (I think at the beginning of the cord).

If it was in the cord, they would recommend palliative care until progression to the point that it was time to say goodbye.

However, from what they can tell, it's touching the cord but not within it yet.

So there is another option, which is take off the leg and remove as much of the tumor as possible. But they're not sure they can get all of the tumor cells where it's touching the cord, and if they don't, it will grow back. In that case, it likely will continue to grow down the cord, and then he will start to lose function of his hind left leg. (It's the front left one they would need to amputate.)

Chemo doesn't address this kind of cancer, and she said that the amount of radiation that would be needed to kill all the remaining cancer cells after surgery would damage the spinal cord.

The vet thinks he has 2-3 months without surgery, and maybe 6 months with surgery if they don't get all of it. If they do get all of it, he could have a normal lifespan (he's a cattle dog, they often live to 12-13 or longer).

The surgery would probably be at least $5,000. Maybe 6 months. But how do you put a price on time with a being you love, even if it's an animal? He has such personality. He's such a sweet, loving, happy dog. He just wants to play all the time - you'd never think he was 8 years old. We have 4 dogs, and he doesn't care what place he's in in the pack. Even with the limp and the pain he's been enduring, there have only been a couple of days when he hasn't been his normal, happy self.

If we don't do the surgery, our choices are put him down now or wait until he progresses further. I wouldn't want to keep him alive just for us if he isn't having a good quality of life.

On the other hand, how do you put down a dog who, when he is just sitting there looking up at you, you would think is 100% healthy?

We've had to make the tough call before, and we knew when it was time. But in that case, the dog went from being fine and us not knowing anything was wrong to suddenly being very not fine. Watching a dog progress slowly into "not fine" is a whole other thing.

I don't know what to do.

$5,000 is a lot of money. We're going to have big bills coming up for our next transfer. But on the other hand (and I realize this is my 4th or 5th hand at this point), would I be able to live with myself if we didn't try? It would feel like we were saying he isn't worth it.

Is it fair to do that to the dog? Is he better off if we just do palliative care until the time becomes obvious? Or is it better if we say goodbye now?

In some respects, it would have been easier if it had been the very worst case scenario, where the tumor was already growing down the spine and surgery wasn't an option.

This is a special kind of hell. I am so devastatingly sad.

Not to whine and fall into a pity party, but just how much more do we have to endure?

I understand that dogs die. They don't live as long as we do. I get that, I really do. But with the exception of one, it seems that ours don't even seem to have normal lifespans.


Hillary said...

I'm so sorry. I don't even know you, and I'm sitting here sobbing. Over the years, losing my dogs have been the hardest, most wrenching experiences of my life--worst than my grandparents dying, and worse than failed cycles. I have no idea what I'd do if I were in your shoes. The 2 dogs I have right now are about the only bright spots in my life, and I know it's probably the same for you. Please know I'm praying for you.

Anonymous said...

So sorry to hear this. I would likely be in the pay 5k and hope the surgery works camp, even if I had to put it on a credit card. Best of luck, I hope your baby is ok.

SLESE1014 said...

I'm with Hillary...I'm cuddling my baby boy dog and crying my eyes out...I'm so very sorry to hear this...I would pay the money, but I've already dumped a ton of cash on my furry babies as it is...they are my children and they are worth every penny...

My sister's dog had cancer and she did palliative care...he did really well for a few months, then took a turn for the worse...that's when she made the decision. She let him decide when it was time. If he's really active and being himself and you're not gonna do the surgery...don't make a rash decision now...let him live it up for the next couple of months...And spoil the crap out of him!

You are most definitely in my thoughts and prayers!

Julie said...

Oh no. I am so sorry. I am crying too. We had to make a quality of life decision with my last dog and I based it on whether he still cared about squirrels and birds, and if he was still happy when we came home. You have such an awful decision and I'm so so sorry for you.

Silver said...

Rudyard Kipling wrote a very poignant poem called "The Power of the Dog" in which he warns against "giving your heart to a dog to tear", about how we choose to attach ourselves to these animals whose lifespan is so much shorter than our own. It makes me cry every time. And it's what stopped our family getting another dog for over 15 years after our beloved childhood pet died (of doggie breast cancer). She managed quite a while on palliative care and when the time came to have her put to sleep, the choice was clear. From my own personal point of view, if you're struggling with a choice about that, then it's possibly too soon to make it. Sending hugs.

Sue said...

I am so sorry. I am crying for you right now. This is so awful. I totally agree that you are put in a place that you don't know what to do and what is the kind thing to do for your furbaby. Life isn't fair at all...and this on top of everything else...even alone, is horrible, but with everything else you have been dealing with...HUGS.

wantitall said...

This is such a terrible decision, I'm sorry u have to go through this. Understanding that $5,000 does not come easy, maybe u can do the palliative care while ur furbaby is still pretty happy and active as u say. This way u don't feel rushed into anything.

Libby said...

I'm really sorry :( Are they certain that the tumor is confined and not in any organs? I only ask because of my personal experience last year. We took our dog to a university vet school for a spine MRI because our local vet thought she had a nerve sheath cancer. Before they would do the MRI though, they wanted to do an abdominal ultrasound to see if anything else was going on. That ultrasound showed spots on her liver, spleen and lungs, and therefore they knew the cancer was very bad and just assumed it was in her spine too(since she was limping - her only symptom). It was a horrible time for us, but our decision to do oral palliative chemo was pretty much made for us since multiple organs were involved, and there was no surgery that would save her. I would take a little time to think it over and maybe even get another opinion. I even regret the liver biopsy we subjected our girl to because a vet professor later told us that hemangiosarcoma can be spread if just one cell is released into the blood stream during a biopsy. Just writing about this brings a lot of guilt and regret to my mind. We try to make best decisions, but there is no best decision before you. I was also appalled when a vet told us we could just end her life at the time of the initial diagnosis. She was still happy, and we were able to spoil her rotten in her last 2 1/2 months. She even got her first squirrel kill in that time (sorry, squirrel). I hope you gain some peace about the decisions that have to be made. Saying a prayer for doggie right now.

lastchanceivf said...

This breaks my hurt. I love my dogs like they are my children and I'm so sad for you. Big hugs.

mara said...

Oh, Rebecca. This breaks my heart too. I love my dogs so much and I can't imagine what I would do in your situation. I am starting to tear up even thinking about it. I will be thinking of you.

I once saw a placard that said, "Heaven is the place where all the dogs you've ever loved come to greet you when you die." How very much I wish that.

Patience said...

I am so very sorry. I wish I had words of wisdom, but we are stuck in a similar quandary. Sending you big hugs!

Mo and Will said...

Oh Rebecca, this is so hard. I am really sorry to read your news. Will be sending many thoughts your way as you figure out decisions - none of which sound like good options. Ugh.


Artemis said...

I am so very sorry to hear about your special boy. I had a similar situation 18 mos. ago. Ten days after I had my second miscarriage I find out my baby boy has a nerve sheath tumor in his right back hock (ankle area). My two dogs and two cats are my kids, so I was devastated. He was a good candidate for surgery, and he followed up with 22 rounds of radiation. He is now cancer free, and I feel so fortunate to have had this outcome. Reading your post brought it all back for me, and I am so sorry that you all are dealing with this. My thoughts and prayers are with you.