Tuesday, July 14, 2009

The Waiting Game

I have to take a couple of the dogs up to the vet today (Lucy and Dorothy, just routine exams), which is pretty much an all-day affair. So, what better time to give you an update on my girl, Sweetie.

As a reminder, Sweetie was diagnosed with a bone tumor on her right front leg. X-rays revealed small spots on her lungs, and an enlarged liver, with some possible problem in that area. A surgical biopsy was done, and the results, which took FREAKIN' FOREVER, didn't reveal too much more information past the spindle cell and anaplastic sarcoma. But the bottom line is this: they are certain the cancer has metastasized. They are certain that the cancer is what will end Sweetie's life, whether through a pathological fracture of her right leg, or because we decide when it is time for her.

Neither of those choices is particularly appealing.

The suggestion of amputation, which I mentioned before, was offered again by the orthopedic vet. But, given that Sweetie has had hip problems for some time, and that the wasting effect cancer so often has on creatures has begun in earnest in her hip area, that is not really an option. Even if they only did a partial, with a prosthesis, it takes several weeks for the prosthetic to be made. Bear in mind, this is an older dog, who also has a major auto-immune disease. Our regular vet concurred with us - Sweetie is not a good candidate for major surgery, or to be on only three legs when two of them are already problematic.

Radiation was mentioned as another option. Of course, there isn't a place in the area that DOES it, which would require frequent trips to have it done. Bear in mind, this isn't for a CURE. Like the amputation, it is only palliative. The one benefit would be a drug post-radiation that would help the bone to re-grow. But there are lots of negatives to this kind of treatment, not the least of which is that it is painful, and requires long-distance trips to get that treatment.

The last possibility is chemotherapy. Again, this would not be for a cure, but for the bone strengthening potential. We will be meeting with an oncologist this week to find out what the pros and cons are for this treatment. Chemo is hard on dogs, too, and we are not willing to put Sweetie through a lot of difficult treatments to extend the quantity of her life over the quality of her life.

And that's the bottom line. Most of the treatments available will not give Sweetie that much longer on this earth, and can make the days she has left filled with lots of travel, more drugs, and illness from the treatments. Thankfully, we have one of the most compassionate vets on the planet, and she has made it clear that if it was her dog, with all that Sweetie has going on, she would not do any surgery on her. And, she has made it clear that should we choose to just medically treat Sweetie, make sure she is not in pain, and just enjoy the rest of our time with her without anything else being done, that that is enough. It isn't about how much we are willing to spend, or that we aren't willing to do whatever our animals need for us to do for them. Sometimes, though, what they need, is to be able to live out their days in relative peace, without a lot of invasive treatments, especially since those treatments won't prolong her life much longer than she would have anyway.

So, we will meet with the oncologist to cover all of the bases, to ask the questions for which we need answers, to know that we are making the most informed decision we can possibly make. In the end, we have to choose what is best for Sweetie, as best we can to take ourselves out of the equation. That is to say, to not hold on to her so long that it is hard on her, no matter how hard it is on us. As another one of our vets always says, this is the gift we can give to her, to not have her be in pain, to relieve her of her suffering, and to let her go.

And even as I type those words, I know what a brutal decision that will be. She is a faithful companion, loving, protective, and, well, sweet. What a blessing she has been in our lives, and will be for a little while longer...


Mary Ellen said...

Ugh...sorry to hear about poor Sweetie's health report.

We had a dog, Siberian Husky, who had been diagnosed with a tumor in her bladder. We brought her to the vet thinking she must have a urinary tract infection because she seemed to constantly be squatting to pee and nothing much was coming out. Anyway, it was inoperable and the vet said eventually it would become totally blocked and she would get septicemia. He told us what to look for...lack of appetite (which was not normal for her!) and in the meantime we just let her live what was left of her life as happy as she could be. The vet orignally gave her about a month to live, but she lived almost 6 months longer before she showed symptoms of septicemia! We brought her to the cottage on the lake in Michigan, she climbed Sleepy Bear Dunes with us, and was spoiled to the max. One day she turned up her nose when I went to feed her and we knew that was it...she was put to sleep that afternoon.

It's such a difficult decision to make, but we knew that we gave her a quality life for the time she had left and I don't regret it. I can't tell you how many of my friends told me to put her to sleep right away and "get it over with". I couldn't do that...and the vet said that we did it at just the right time, before she was feeling pain. She just had the discomfort of feeling like she had to pee a lot and that didn't seem to slow her down.

You'll know what's best for Sweetie and I'm sure you'll make just the right decision for her. Dogs give us so much love and trust, I'm sure Sweetie trusts you.

All my best to you, your partner and Sweetie.

Rabble Rouser Reverend Amy said...

Thanks so much, ME.

And thank you for sharing the story of your girl. I am sorry for your loss. It does sound like y'all let her live out her days with dignity, joy, and love. One cannot ask for a whole lot more than that (and our Sweetie loves her food, too - she was emaciated when we got her, and food is one of her favorite things).

My vet today was so great. We talked abt the whole amputation thing, and she reiterated that Sweetie is DEFINITELY not a good candidate for any kind of major surgery like that. At this point, we will do for her what you did for your Siberian Husky. Make sure she is comfortable, love on her, and let her go when the time comes.

Thank you again for sharing your story. I really appreciate it, Mary Ellen.

Logistics Monster said...

Rev - I am soooooo sorry to hear this news. You are doing the right thing - even if it's not the easy thing...

I had a dog whose kidney's started to fail at age 7, I changed her diet and gave her meds for a year. When it became obvious that the quality of her life was over - I let her go. I still cry about it. I've done it two more times after that - but the life you have with them is worth it. Wouldn't you say?

Rabble Rouser Reverend Amy said...

Hey, LM -

Thank you for the support, and for sharing your story. It is hard, I know - we lost three of our animals in one year (two greyhounds and a cat) not long ago. It was difficult indeed. And I can sure understand still crying over losing your young one - that is so sad...

But yes, it is so worth it having these wonderful members of our family. Sweetie has been a real gift to us in so many ways. Despite the difficulties she has had (and the tremendous vet bills to go with them - let's put it this way - we had to give up our dream of getting a boat), we would do it all over again any day of the week. Unfortunately, we are at a point that all the money in the world can't save her. It can prolong the quantity of her life, but not the quality. I'm not willing to do that to her - I think she deserves better than being on a ton of meds, dealing with a bunch of side effects, having to go back/forth all the time to the vet for treatment, the closest of which is 1 1/2 hrs away...That's not how I want her to live out her days on this earth. Like I said, she deserves better.

And I can't even write abt it without crying...

Thanks again, friend.

Anonymous said...

Oh, Rev, I'm so sorry to hear about Sweetie. I'm right there with all the others...it's the quality of life that's important. You've made the right choice for Sweetie, hard as that choice is.

I've taken my Raymond off all meds, no more visits to the vet, just lots of love. And when he's ready to transition, he'll let me know, I have no doubt. Until then, he'll get more love than that cat will know what to do with!

My thoughts are with your whole family. Sweetie couldn't have found a better home, and when it's time she'll make that transition filled with love.

Rabble Rouser Reverend Amy said...

I appreciate that, SF. Thank you. Hard as it is, we think it is the right decision.

And I appreciate your filling me in on your beautiful boy. It sounds like we are in similar places these days. Raymond is lucky, too, that he has you. All the love one can take is a mighty fine way to live out one's days, if you ask me.

All of y'all, ME, LM, SF, are such good, tender hearted, loving people. It is an honor to know you.

Anonymous said...

Oh Rev...such a tough time for all of you. I completely understand how you're feeling. When our tortie, Sugar, was diagnosed with renal failure, we did what we could to make her last days comfortable (including letting her eat anything she wanted...that horrible low protein cat food sucked, as far as she was concerned), and when the time came, she let us know.

Hugs and love to you all.

Rabble Rouser Reverend Amy said...

Thanks so much, bluelyon - I appreciate it.

Yes, since Sweetie is starting to lose weight fast, we are restoring the regular wet food (rather than the weight management stuff). She's mighty happy abt that...

I am sorry to hear abt your Sugar, though. I have a tortie, too, Punkin' - she thinks I'm her mom. Anyway, thank you. It means a lot...