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Argus Update: The New Normal

January 31, 2011 Fido 1 Comment

Argus received his third chemo treatment last Wednesday and bounced back quickly. They preempted his vomiting by giving him an injection of anti-nausea medicine when they administered the chemo. It was clear he was more tired than usual for a couple of days, but things were quickly back to normal. His hair is coming in nicely and the incision is fully covered. Isn’t he handsome?

I was nervous going into this treatment. January 15 marked three months from his diagnosis. Our vet told us that the average prognosis for metastasis if we were to do nothing is three months. We obviously opted to treat him fully (amputation + chemo), but there are no guarantees. Argus has his blood counts tested every week and he is consistently in the normal range, and this visit also included body scans to see if tumors have formed on his lungs and liver. No spreading! What a relief!

I’m also proud of my big dog that he will lay still for the technicians while they work on him. When we first started our treatment there, they told us it is a policy that they have to sedate any animal over 25 pounds, but they make an exception for Argus because he doesn’t give them any trouble. I am sure it’s because he’s lazy and he enjoys laying down while people fuss with him. I’m just glad they don’t have to pump him full of more drugs! Remember the last time he was fully sedated?

Look at his poor little tongue hanging out

He has adjusted very well to life on three legs; I wonder if he even remembers having four… We have really worked to increase his endurance and he can walk a couple of miles at a steady pace with minimal stopping. Around 3 PM every day, he finds me and engages in a “conversation” to remind me that he would like to go out for a walk. It’s kind of like a low growl, usually with an exasperated “ahem” at the end. He does this when it’s time to eat, too.

Greg and I took him over to the beach for happy hour on Friday and I got a good video of him running with Greg. Walking is still very “hop-along” and it seems labored, but he can run almost seamlessly. He even has good control in doing a tight turnaround.

Thanks to everyone who has called and emailed and texted to ask how we’re getting along. Your concern is much-appreciated!


43 Staples

November 20, 2010 Fido No Comments

At least I think I counted them all.

Argus has 43 staples holding that big gash together. Yesterday’s post didn’t really show the magnitude of the wound, so I thought I’d post a picture of what we’re dealing with. Sorry in advance if you don’t like this kind of stuff. The close-up shot below is somewhat graphic; consider yourself warned. I plan to post updates of the wound pretty regularly so we can watch it heal. The staples come out on November 30.

We have had much less eventful nights, which is a relief for all of us. Argus is getting around reasonably well on his own, though he doesn’t do much moving during the day. His usual MO before surgery was to spend the first part of the morning in his chair, then move out to the deck to lay in the sun for a little while before retiring to the bedroom to watch the goings-on at the front of the house. He’d start bugging me by 3 PM for an outing. Today, he only moved from the chair to the couch and back to the chair (and made his moves when I was gone).

When I got home from Book Club Thursday night, Argus was at the door to greet me. I think he forgot what he was doing for a minute because he made a running LEAP off the deck to chase the squirrels off. Thank goodness his instincts kicked in fast enough that he didn’t crash! Although I got quite a giggle from the stunt, it must have hurt and he’s been moving much more gingerly since. His walk this morning has been shaky and it’s clear he doesn’t feel good. It’s a rainy Saturday and I am content to sit with him on the couch all day.

Here’s the wound:

Day 4


Argus is a Tri-Pawed!

November 18, 2010 Fido 8 Comments

Our sweet boy has had a traumatic week. The good news is that the worst is over. I think even Argus can see the light at the end of the tunnel at this point.

Melody and I drove Argus to Davis on Monday morning to meet with our student doctor and the teaching professional for a consultation. Argus has the waiting room thing down and was not frantic to leave, as he often is at our normal vet’s office. In fact, he made himself right at home!

Our appointment started on time and I was immediately put at ease. Our student surgeon, Kristy Bowles, and her teacher, Dr. Lauren Larue, were very professional. While I had done my research and already knew most of the information they shared, they did answer my few questions honestly and compassionately.

One question I am thrilled I thought to ask: How big will the incision be? My expectation was literally 3-5 inches — you know, about the width of his arm. Dr. Larue held up her fingers to show the distance and it was LONG. Like, a foot long. I did not realize they were taking his entire scapula as well as the arm! Thank goodness for expectations being set!

They also managed my expectations regarding his homecoming. Both doctors seemed quite concerned about the size of “this big guy” and his ability to find balance and coordination immediately. In some cases, they keep the amputee for a couple of days so their team of aides can work with him and send him home set up for success. They would not know until Wednesday morning if we’d be able to take him home that night or if we would need to wait.

I waited impatiently all day Tuesday for the call from Ms. Bowles to let me know how the surgery went. The call finally came at 5 PM and was positive. The surgery was a success! She assured me that she would call me as soon as she got him up on Wednesday morning to see how well he was ambulating.

Wednesday’s call came at 8:20 AM. She was surprised and delighted to inform me that when she walked in to get Argus, he popped up on three legs as if to say, “Good morning!” What a good sign! She was able to walk him out to go to the bathroom, assisting him with a sling under his chest and he was adapting very well. We could take him home! Greg and I left at 3 PM to go get him (it’s a ~2 hour drive to Davis from San Mateo).

I was nervous. I brought a roadie in the car, just to dull my nerves a bit. Specifically, I kept picturing the estimated length of the incision. I don’t do well with stitches or staples and I knew they’d be right out there for the world to see. I also knew I needed to suck it up. So I sucked up some wine first and that helped!

It was dusk when Ms. Bowles walked him out to us. It was clear he was pretty drugged-up, but his tail did wag when he saw and heard us. It was pretty amazing to see him “walking” with a slight assist. From my vantage point for the below picture, I can’t see the damage and I think he looks great!

He was walking reasonably well, I’d say. Inertia kind of sets in on both ends. It takes him quite a bit of cajoling to get going, but then he gets on a roll once he starts. It was ungraceful getting him in the car, but we were finally on the road. I opted to sit in back with him. It was all I could do to comfort him (and be comforted myself).

The car ride home was uneventful. He settled well and rested his head on my lap. Once we got home, we fumbled around to get him out of the car. We ended up just having Greg carry him into the house, knowing he had to be in pain from all the movement and still very tired and woozy from the drugs. He seemed happy to be home, especially when he heard us preparing his dinner. Some things never change…  He waited patiently on his bed, rather than at my feet.

Obviously, you can see the large area they shaved for the surgery, and you can see part of the incision. There is no “stump” left. The whole area looks very swollen and bruised. After dinner, I sat on the floor with him and he fell asleep with his head in my lap. I was confident he would sleep well through the night based on all the drugs and the exhausting day overall.

I could not have been more wrong. Misery loves company, as they say, and we were all miserable.

Argus cried all night long. He wasn’t comfortable on his bed on the floor in our room, even with me laying next to him. We lifted him into our bed so he’d be cocooned between us. He still cried. Even with pain meds administered at 7 PM and 10 PM, we gave him more at 2 AM. And still there was more crying. He tried to get off the bed on his own, and luckily Greg woke up and caught him before he fell off. I walked him out to the living room and laid next to him where we had been earlier in the evening. He still cried. Around 4:30 AM, he got up, wanting to walk. He walked to his favorite spot on the couch, so I helped him up. I laid next to him and he still cried. He wanted up again, and he led me into our bedroom and crawled up into bed with Greg. More crying. None of us got any sleep. Greg and I were at our wit’s end, wondering what was wrong and how to make it better. Is this what parents of newborns go through??

Finally, when the sun came up and everyone was up and moving, he quit crying. We have no idea why he was crying to begin with or why it stopped at that particular time. Maybe he’s afraid of the dark all of a sudden?? I was concerned about spending the day with him by myself based on how laborious the night was. Greg went in to work late and busied himself building a ramp for easier access to the yard.

We got him to go down the ramp to try and potty, but he was having none of it. He did seem to be more stable standing on his own and we lingered a few minutes.

Looks pretty precarious, doesn’t he? I fashioned that bandana around his neck as a quick way to grab him if he starts to go down. It isn’t as abrasive as his collar and gives him a bit of flair! From there, the day got much better. Argus settled down and started to snooze. I cleaned up the “slumber party” that happened in the living room overnight and made breakfast. At least he wasn’t crying!

Needing a little fresh air myself, I barricaded him in his corner and went for a run. While I was nervous the entire time (especially since I forgot to put his anti-chew collar on), I knew I had left him in a safe spot and we both needed the solitude.

Here’s what I found when I got back:

Argus made his way through my barricade (a chair turned on its side, covered with pillows), walked the ~10 doggy steps across the living room, and made it up onto his overstuffed chair BY HIMSELF! And, he didn’t tear all his staples out.

I am in awe.

He has been in the chair for at least five hours now, and has even gotten himself up and turned around 180 degrees to find a different comfortable spot. He greeted the UPS man with a growl and then graciously accepted the treat he was offered. Things seem as normal as ever.

We’ll see how tonight goes when the lights are out, but I am hopeful that we have his pain under control and he feels more in control, in general. With two competitive triathletes in the house, I guess Argus is making his statement as a successful tri-pawed!


An Expensive Week

October 22, 2010 Fido 2 Comments

Last Friday, we were devastated when we learned why Argus was limping: there is a tumor on his left paw at the “wrist” joint. In 7 days, we have spent $1236 diagnosing the tumor and it has been confirmed as the worst kind of canine bone cancer – osteosarcoma.

We now know more about bone cancer than anyone outside of the veterinarian community should ever know. And we’re not alone. Osteosarcoma affects roughly 10,000 dogs each year and it occurs most prevalently in large breed dogs. It’s a terrible disease that quickly spreads and robs a dog of any chance for a long life. Here’s how our week unfolded:

We spent last Friday and Saturday in shock. We were so sad and weepy; it was all we could do to cling to each other and Argus. Greg researched a special cancer-fighting diet that he believes will help, so we ran errands together to pick up the necessary ingredients on Saturday afternoon. Dr. Sutter called to check in and answer any questions we may have since I was a disaster in his office on Friday. Greg appreciated being able to talk with him first-hand and have his questions answered directly rather than me trying to remember what I had been told. Sunday felt more like a normal weekend day with a road trip to Sacramento. Neither of us shed a single tear that day! My eyes finally de-puffed a little and I didn’t feel so desperate.

Monday, we were back at the vet’s office for more tests. Poor Argus gets nervous every time we pull into the parking lot. I wasn’t sure how long he’d have to be there, so I was “that doggy mama” who brought her own dog’s bed in with us so that he’d have something familiar with him all day. The nice people there smiled and politely obliged me; they deal with crazy pet people like me every day. He was a good boy and sat still for his full-body x-rays, ultrasound, and blood work without the need for sedation. I got the call from Dr. Sutter at noon. Good news! Nothing has spread (yet) and his blood work came back clean. I collected my dog and left the office $460 lighter.

The next step was to meet with the surgeon and oncologist on Wednesday morning. Greg attended this appointment with us. I was armed with pen and paper this time so that I could take notes and keep everything straight. This appointment lasted over 90 minutes and we were given several options (as we heard and understood them):

  1. Do nothing. Prognosis = a few months at best. Cost = pain medication
  2. Radiation. Prognosis =  several months probably. Cost = $8000
  3. Chemotherapy. Prognosis = average of 12 months. Cost $3000
  4. Amputation. Prognosis = average of 12 months. Cost $4000
  5. Limb Spare. Prognosis = average of 12 months. Cost $7000

I asked them both if there was any chance the tumor was perhaps a fungal infection instead. They agreed with Dr. Sutter that it was not likely, but could not entirely be ruled out. Unfortunately with a fungal infection, you can’t just treat it with antibiotics (but they appreciated my optimism).

I asked each of them separately what they would do if the decision was theirs to make. Both doctors said that Argus is a young and otherwise healthy dog. If we can save his leg, we should. Dr. Cadile, the oncologist, said that there are some studies indicating that leaving the primary tumor in place helps the body stave off metastases. Greg and I agreed: if all things are equal (cost and prognosis), let’s proceed with chemotherapy rather than amputation. It’s still a lot of money to spend in the hopes of getting one year with Argus, but one year is better than six months. The only thing left to do was to confirm that the mass is not a fungal infection, which could be done with a cytology. Dr. Banz estimated this at $60 + sedation. We agreed to move forward with this procedure. I hated the cloud of uncertainty hanging over us.

Greg left for work and I left Argus there for the procedure. When I picked him up a couple of hours later, he was a drunken sailor from the sedation medicine. He couldn’t walk a straight line and his back legs wanted to slide out from under him when we stopped for a few seconds. It would have been comical if it weren’t so tragic. I lifted him into and out of the car, then got him in the house and settled on our bed. His poor little tongue was stuck outside his mouth until I wet it and pried his jaw open to put it back in. He slept the afternoon away and finally came around enough to have dinner.

As it turns out, Wednesday’s meeting was a $453 misunderstanding. I got an email from the oncologist on Thursday morning that summarized everything we talked about. This letter indicated that chemotherapy is not a standalone treatment method, the prognosis with surgery alone is 5-6 months, and the prognosis with surgery + chemo averages 12 months. Furthermore, the exact cost of the chemotherapy drug Carboplatin was provided and the cost is $4800 (not $3000). We were back to square one. The cytology was a $233 (not $60) hail Mary that failed. The test came back as confirmed osteosarcoma. Our spirits were low last night.

My heart is broken that Argus is dying. I have additional heartburn because Greg and I are no longer on the same page about his treatment. With the new information in the summary letter, I believed that the cost is too great to amputate and/or pursue chemotherapy. Even doing nothing, the pain medication will cost us somewhere around $2000 if he lives six months. Greg has been adamant on pursuing amputation, even with its hefty price tag. I approached the subject via IM today, hoping to diffuse some of the emotions that are inevitable with this kind of conversation. The good news is that he finally agreed that spending $4000 (on top of the $1200 that we’ve already spent) is too much to only buy a few extra months with Argus. WHEW! That said, we also agreed to exhaust all possible options for a cheaper amputation facility.

I got in touch with the vet teaching hospital at UC Davis this afternoon and got some very good news. Their cost for the amputation surgery is $750 all-inclusive: two nights in the hospital, anesthesia, surgery, and pain medication (morphine) post-op. I tried to mask my amazement and delight when she revealed that number. Dr. Sutter agreed that this is a very good option for us to pursue and got to work on getting Argus’ records faxed to them. We will find out on Monday whether our case has been accepted. Our fingers and paws are crossed!

In the meantime, Argus and I went for a walk today and he seems in good spirits. He was excited when Greg came home from work and he still has quite an appetite, watching us intently as we prepare his dinner. I am relieved that his pain seems to be under control for the most part and things seem reasonably normal. Greg and I are getting ready to go out to dinner tonight and we feel much better and more hopeful than we did a week ago at this time.

If anyone has any other ideas for remedies pre- or post-amputation, please share them with me in the comments section!