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New Symptoms

March 23, 2011 Fear, Fido 1 Comment

Argus has been his normal self, which has been a blessing to us. For all intents and purposes, he doesn’t know he’s sick. We have been doing our best to live in the moment with him and not think too much about the reality of it all. He still gets excited every time one of us puts shoes on or grabs car keys. He still barks incessantly at the mail person, begging for (and receiving) treats. He still eats his food and begs for ice cream every time the freezer opens.

A few things are different as of the past couple of days. His eyes always have dried “sleep” in them in the mornings, but now they are much more goopy — and they are leaking this goop all day long. It doesn’t appear to be discolored (like an infection), but it’s definitely out of the ordinary.

The other change just happened. I came into our bedroom and found him napping, which is not unusual. What did alarm me was that his upper body shivers/quivers with every breath. We know the cancer has spread to his lungs and our vet mentioned a symptom of end-of-life will be labored breathing.

I have a call into the vet to ask about this and see if it’s time to start the heavy duty pain meds. In the meantime, I took a video and am asking for anyone’s opinion on what this might be. Perhaps a fever, as one friend suggested?

The one thing I do know: I’m not ready.

UPDATE March 24: We talked with our vet last night and he was concerned that Argus’ systems are busy trying to fight more cancer and are unable to fight things like small infections (his goopy eyes). The shivering could be a fever he’s unable to fight, or his response to pain. We picked up a prescription for Prednisone (steroids) last night to help with pain and he has responded well. No more shivering, the eye goop is less today, and he still has a good appetite. Thanks to everyone for your kind thoughts and words!


The Phone Call

March 9, 2011 Fido 12 Comments

My eyes stung with tears.

I was quietly minding my own business in a local coffee shop when my phone rang. It was earlier than they normally call.

“Dr. Frasier would like to discuss the test results in person. Can you please return to the clinic?”

And just like that, I knew. Doctors don’t wait to give you good news in person. If it had been good news, they would have proceeded with today’s regularly scheduled treatment. But they wanted me there to discuss it.

As the tears burned and my face flushed with heat, I called Greg. I knew he was in a meeting; I called anyway. I felt so alone and — selfishly — wanted someone else to feel as scared as I did. He said to hope for the best. I smiled to no one and said I’d try. I packed up my things and drove to the clinic.

I might as well have had a scarlet letter on my chest when I walked in. The front desk people knew why I was there; I didn’t need to check in like everyone else. A doctor who often greets me stopped her conversation with another patient to let me know someone would be with me shortly. I didn’t even get the chance to sit down before a woman quickly ushered me to The Back.

“There are a lot of people in the waiting area. Let’s bring you to a room.” I took deep breaths and held back more tears. She didn’t make eye contact.

Dr. Frasier came into the sterile room and nodded, confirming what she saw all over my face.

Argus’ cancer has spread.

She very kindly explained the test results. In between medical jargon, she gave me many heartfelt apologies on behalf of the entire staff.

“Argus is everyone’s favorite.”

“He is such a dear boy.”

“We argue over who gets to treat him each time.”

“Argus is really something special.”

As special as he is, the chemotherapy was ineffective. She explained another study we could join, which might buy us an average of nine months. It would require at-home treatments that I would administer twice each week plus one injected all-day treatment every three weeks in Davis at a cost of $500 per treatment. There are many side effects to consider. And again, the purpose of this study is not to cure the cancer, only to slow it down.

If we do nothing, the cancer will continue to metastasize and they expect his quality of life will diminish to a critical point within two months.

The end is near. My heart is broken.


Feed Me!

October 28, 2010 Fido, Food 3 Comments

I mentioned that Greg found a diet for dogs that is shown to help their bodies respond to cancer. Here’s an excerpt from The Dog Cancer Survival Guide:

Did you know you can help your dog fight cancer at his next meal?

The right foods – many of which you probably have in your house right now – can be powerful weapons for a dog with cancer. Putting your dog on a Dog Cancer Diet, as outlined in this report, accomplishes two things.

The Dog Cancer Diet:

1. Fights Cancer. It’s probably what you want the most – for the cancer to just go away. While no food is that kind of “miracle cure,” there are some that can “go after” cancer tumors.

2. Supports Immune Response. The body has a natural defense system for cancer, called the immune system. Unfortunately, dogs with cancer have a suppressed immune system, which means cancer can run roughshod over the body. Foods that boost the immune system help the body’s natural defenses repair themselves.

Greg is absolutely convinced that this diet — and the supplements, of course! — are going to help Argus cure himself of cancer. I am not convinced. I agree with the logic, mostly because it’s the same logic that applies to humans. And the author of the book is correct, actually. I DO have many of those foods in my home right now, because Greg and I eat them and we eat them for those cancer-fighting reasons. I assure you that it isn’t because brussels sprouts are my favorite vegetable.

But the data for osteosarcoma is clear: my dog will die of this disease. Now that he has gotten it, it’s too late. And, let me remind you that we were not feeding him Ol’ Roy to begin with. Argus was being fed a raw diet. Raw chicken backs, turkey necks, lamb necks, turkey hearts, and his favorite — tripe. Pretty healthy stuff, all things considered.

Even if my heart isn’t totally into all the claims surrounding this diet, I have agreed to put it into practice. Lucky for Greg that I have, as it is really a two-person job (unless you have all day to spend at this). After our first batch took pretty much an entire Saturday afternoon and netted us only four days worth of meals, we knew we had to streamline our process. If this were a raw diet and/or my dog enjoyed vegetables as much as I do, this would be a piece of cake. It’s not and he doesn’t, which leads us to why there is a process involved at all and why we need to fix it in bulk.

Whole Grains — brown rice or slow-cook oatmeal
Protein — chicken, turkey, lean beef cuts, liver, fish
Vegetables — shiitake mushrooms, brussels sprouts, broccoli, cauliflower, squash, red/yellow peppers, dark leafy greens, parsley, garlic, banana, apple (I realize these last two are fruits)
Calcium — cottage cheese
Other — fish oil, krill oil, shark liver oil, enzymes, black strap molasses, egg, apple cider vinegar

Part of the rationale behind this diet is that your dog’s body is busy trying to fight off cancer, so you should make digesting his food easier for him. Here’s how to do that:

  1. Cook the meat at a certain temperature as not to cook all the good stuff out.
  2. Grind the vegetables up and hide them amidst a bunch of meat so your dog can’t taste them.
  3. Dissolve the oil pills in hot water because he will suss them out if they’re whole.
  4. Add cottage cheese just before serving so it doesn’t separate.
  5. Sprinkle enzymes on so they can begin breaking down the food before it goes into the dog’s body. This means preparing his dinner 30 minutes before it’s time to eat so the enzymes can begin doing their job.
  6. Explain to your dog why his food is sitting on the counter and he is not yet allowed to eat it.

On our first attempt, Greg and I were working side-by-side in the kitchen. I got the whole grain brown rice going on the stove and began cutting a selection of the vegetables, then quickly steaming them to soften them a bit. Then I put batches of them in the blender to form a puree. Greg was working on the meat. Cutting it, quickly boiling it, removing fish bones. When the rice was done, we added the veggie glop to it. Then the chunks of meat. After a good mixing, it went into the freezer in individual portions. We were both exhausted and we didn’t even know if he’d eat it!

The good news/bad news is that Argus LOVES his new food.

Here’s what we’re doing now:

Borrowing Pete’s Vita-Mix so we can grind the veggies with minimal chopping and no steaming. Cutting meat into bite-sized pieces and adding them to the Crock Pot, along with the rice. Combining all ingredients and putting them into individual servings.

We got 10 servings out of this batch, which is much more reasonable. He’s been on the diet for a week now and he really does love it, so we’ll keep at it. Of course, there is no way of knowing if it is helping or not, but if it makes Greg feel good, I feel good.

If you weren’t convinced we are crazy for all the endurance sports we willingly participate in, what do you think now?


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!