Sunday, March 15, 2009
Then, a wonderful present from Bri! If you believe in that kind of thing. We do. We got a bunch of weird signs and coincidences, long story... one involving Stephen Colbert that even the skeptical Mark thought was way bizarre... I even had the adoption coordinator in tears at the Brian+Brad story.
Nothing and no one will ever replace Brian. I can't repeat this enough to insensitive folks who suggest that we did. It annoys me that they even think this, ugh. What should we do instead, sulk in self-pity for another couple of months or so? We already grieved while he was still with us; wish I hadn't so much. No thanks.
But Brad truly keeps us busy and distracted, no time to feel sorry for yourself if you have to care for a little one, guaranteed (Though my mom lets me know almost on a daily basis that she prefers a fur-less one).
I have yet to get Brian's urn for his cremains. We picked one that will have his photo laser-etched onto the wood. Real nice. I picked this snapshot where he had his head cocked to one side - that really makes us laugh. Someday I'll make a memorial to include his collars and locks of his beautiful, golden hair, that I clipped before he passed. Sara C. gave us a memorial frame, with a touching poem for furry loved ones lost. We also got a bunch of sympathy cards and memorabilia from friends and family. The thoughtfulness is well-appreciated!
Someday we'll be able to look at his photos and videos and smile at the good memories. Not now, but someday. :)
We were moving along with the whole grieving process, at a normal pace, I guess. Tufts did the necropsy and saved us a trip by mailing the ashes. Needless to say, coming home to Brian "waiting" for me as I got home from work hit me like a ton of bricks. I would've preferred to see him hopping up on the radiator to get a better view of us pulling into the driveway, barking excitedly like he usually did, but oh well. Mark had carried Brian's suddenly frail 78-pound body out of the house, in his arms like a baby (a nasty vision I won't ever be able to get out of my head) that fateful Monday on the 16th of February, for what we thought was a little bump in the road, nothing a little IV drip at the ER couldn't cure. Little did I know that he would come home in a tiny FedEx box three weeks later.
I have mixed emotions about the necropsy report as well. We wanted ANSWERS, and boy, did we get them. Turns out he had multiple myeloma, which accounts for less than 1% of malignant canine tumors. Towards the end, it metastasized to a point where he had lesions everywhere. And I mean everywhere. Sure, he was sleepy and ate little, but we had no idea it was this bad. The number of organs that weren't affected, I could count with five or so fingers. If only these stoic pups could talk.
I am refraining from wallowing in "what if's"... What if we did a simple blood/urine test to check for certain proteins? Would've nailed it down. What if we diagnosed it earlier, could he have enjoyed a year-long remission? This type of cancer is known to respond to prednisone/melphalan chemo agents, I was told. After all, we wasted a total of 3 months going in the wrong direction, depriving Brian of the potentially helpful chemo agents while the cancer ravaged along. What if I sought a second opinion sooner and broke loose from the pessimistic, overly practical surgeon-vet, could I have given him a better chance at a remission via the chemo route? Actually, it was the fourth opinion that I ended up being most comfortable with... And, did pesticides, or his Mitaban dips (as a 6-month old puppy being treated for mange) cause this, were they nasty carcinogens? After all, it took us decades to realize that asbestos, cigarette smoking, lead paint, etc were cancer-causing, right. You never know. So, yeah, I just did wallow in what if's, I can go on and on. Just needed to get it out of my system. :|
In retrospect, the symptoms from Christmas last year do suggest that his cancer was already in full force. The casual yet peculiar observation that the regular vet made about Brian's pupils being of different sizes, perhaps was a hint of the brain tumor silently a-growing. I'd certainly like to believe that we did all we could.
"He's no longer in pain" blah blah yadiyada. I know that. Doesn't mean it doesn't hurt like hell. I admit, I'm selfish and I want many more years with him! He really was a happy, loving and funny companion who fought hard against this disease. He never failed to let us know that he loved us and loved being with us, tumbling down the stairs (always gave me a heart attack) or rolling on his back or jumping up on the bed just to say hi. His happiness shone through the broken body for as long as it could. Murderers and rapists deserve this, not Brian.
We really miss him.
Saturday, February 21, 2009
He left our lives as quickly as he came into it.
Got to NEVOG at 7pm. Said our goodbyes for a couple of hours. Vet asked if we wanted to take him home one last weekend, as he really wasn't in distress though he was in a near-comatose state. Slim chance he may still snap out of it, though our hearts said he wouldn't.
We decided against taking him home. This is not how I had hoped for things to end; he wasn't really there anymore. He seemed like a dog on auto-pilot, an empty shell. They said we had 3-6 months, and it has only been 4 weeks since the diagnosis. Cancer does what it wants to do.
But, in his fleeting moments of consciousness, he did walk around a bit, lift his paw at his dad, lick peanut butter of my hands, and perk his ears up at the sound of his leash being shaken! Definitely moments of his old self poking through the brain swelling, I know it. I lost it when he reached for his dad with his right paw. It was such a Brian thing to do.
Then, we decided it was time. We laid him on the bed that I had lovingly sewn for him during his happier, sick-free days. My beautiful baby went peacefully at 9pm on February 20, 2009. He was finally released from his broken body. Barely two and half years old.
Wait for us babe, 'til we meet again!
Click here to view his memorial from Dee and the wonderful BCD group.
He had a busy day: hung out with dad while the fence was being fixed, went with mom to work for half an hour while dad was shopping at Home Depot, stuck his head out of the car for some sniffing, napped a little, watched the world go by through the glass front door (his fave pastime).
This is how I want to remember him. I will be forever grateful for these photos.
Hilarious video from 01/28/2009.
Good morning greeting, 02/07/2009. Now, who wouldn't want to wake up to this every single day? :)
Friday, February 20, 2009
Brian is crossing the bridge tonight. Vets, Mark and I, and Brian, are in complete agreement.
It's pointless to stay at work, of course. So here I am, just waiting for hubby to get home. The drive to NEVOG, where Brian is resting comfortably, will be long and difficult.
Please keep him in your thoughts and prayers as he starts a new life with no pain! Finally, he can run and jump and bounce around like crazy once again!!!
Wednesday, February 18, 2009
Got the call from the attending vet at the doggy ICU today. No seizures - they seem to have halted the cycle. And, no tumor lysis complications (dog can drop dead from tumor cells dying way too rapidly from the chemo, if so)! And, he ate and stood up, inspite of being drugged up on phenobarbital! And, he's going home tonight! Woohoo! And I get to drive to Waltham again, lol...
Tuesday, February 17, 2009
Since this is a "medical journal", first and foremost, I am obligated to document the frequency:
02/15/09, Sunday - 3am, lasted around 1 minute
02/16/09, Monday - 1:21-1:24am
He did snap out of it both times. Came out of it confused and energetic. He was looking for us, looking for reassurance afterwards. Later on I find out that epilepsy is not that uncommon in canines, his possibly being a) totally unrelated to the cancer, b) unrelated but triggered by the cancer, or c) a result of brain metastasis. Well, I'm not going to lie. It's probably c). We won't know for sure, and we won't go through crazy, expensive MRIs or CAT Scans just to satisfy our curiosity. The idea now is to address the primary cause, whatever it is, and hope that it will consequently address the symptoms. May it be brain metastasis or unrelated epilepsy.
He had his lymph node biopsy and bone marrow aspirate scheduled for Monday. Seizures greatly complicate things. Is he still a candidate for surgery, still able to go through general anesthesia? We're caught between a rock and hard place here - damned if we do, damned if we don't. I mention the "E" word to everyone, making sure it was clear that we wanted what was best for him, if all the vets decided so. Mark even took the day off, something he never does, in preparation for the worst.
Visited and consulted with the regular vet Monday morning. He bounded in and pulled on his leash, of course, as if nothing happened the nights before. I'm such a regular now, that she doesn't even charge me for the consultation! Bless her heart. She discusses the new situation with the surgeon vet, and they say including valium in the anesthetic mix will make it safe.
02/16/09, Monday - 10:51-10:54am
We get back from the vet visit, and he has yet another one. By this time, I am on emotionless/efficiency mode, noticing the onset or "pre-ictus" signs, making sure he has a soft bed to convulse on, holds him steady on his side, talks to him while it is happening, looking into his lifeless eyes, comforts him as he regains consciousness. Having sensed from the vet visit that these seizures were non-life threatening, I hope for the best, lay several blankets and dog beds down for cushioning, and head for work. I am guilt-ridden for having missed so many work days already, and today was the busiest day of the week (group meeting day!) Vets say surgery can proceed tomorrow. Everything is okay, right? Off to work.
A decision I will regret later on.
When I get back at 7pm, only one dog greets me by the door. Big concern, first time this has happened in Brian's two years on earth. Then, I see him standing up in the middle of the living room, completely disoriented. He does not recognize me, is almost terrified of me, then urinates. These are clear signs that he just came out of one. From the saliva stains on the floor, it looks like he had at least 6, throughout the day. I felt so bad for abandoning him on possibly the worst day of his life. I wait for hubby to get home.
02/16/09 - 7:10pm, twitching of the lips
-8:00pm, lasts around 5 minutes
-9:38pm, while I was on the phone with the on-call oncologist at NEVOG
On-call onco at NEVOG says once the dog has one seizure, it sets off more. And that the cycle has to be broken with anti-convulsive medication, now. So, off we were to the Animal ER at Rocky Hill. They keep him from 10pm to 7am, and he has 3 more seizures, all successfully halted by intravenous Valium. They usually like to keep seizuring dogs overnight, for observation. We picked up one sleepy dog at 7:30am, that's for sure.
While all of this was happening, I was truly convinced this was the sign we needed. That Bri was telling us it was time. But all the vets (ER+regular+onco+surgeon) tried to get it under control, did get it under control for now, and all wanted to give him a chance with addressing the primary cancer. Their philosophy is, by addressing the primary cause, any other side symptom (including brain tumors, or epilepsy, or whatever this is) should be kept at bay. I kept asking, isn't this a lost cause? I almost felt embarrassed that I, his own fur-mother, was the one secretly giving up on him, while all these medical professionals had a sliver of hope for giving him the quality of life in his remaining time.
If you had asked me 6 months ago if I would push this far, I would've responded with a resounding "No way". But you never really know how you're going to react, unless you're faced with the decision, right then and there. There is still one stone left unturned. I just don't want to have any regrets for not having tried our best to fight with him.
Needless to say, he remained seizure-free all day today, peaceful and compliant while drugged up on Valium. Racked up some serious miles on the car: Went to W.Hartford, CT for his scheduled biopsy, only to decide in the lobby that he was too beat up from the seizures to undergo surgery. Surgeon vet talks to the head honchos at NEVOG, and sent us there to proceed with anti-convulsive + chemo treatments. An unexpected 1.5 hour drive one way, but hey, we've got our momentum going. We basically bypass the biopsy and just start the chemo right away, under the assumption that it is lymphoma.
(Side note: Bri pees on his daddy while snuggling together in the backseat, having been duly hydrated by his IV drip all night but too drugged up to think of where/how to pee! Totally funny... to me, at least)
Onco vet there said he put up a fight when they tried to stick a needle in him, which is good! Alert is good! Bri gets to stay there for two nights, while they observe him post-chemo. We sign a "Do not resuscitate" form, in the event of tumor lysis complications.
Nighty night Bri, enjoy the round-the-clock lovin' from the nurses...
Thursday, February 12, 2009
- Onco vet says she doesn't believe the conclusions of the bone biopsy report. Wording was a bit iffy to her, and she'll have the slides forwarded to her trusted pathologist. Never hurts to get a second opinion. The case, apparently, is so interesting that she is discussing it with colleagues at work. She also said that the little masses in his chest were in the lymph nodes and not in the lungs. Wow, a little ray of sunshine there! She wants Brian to stop the Deramaxx and switch to Prednisone.
- Surgeon vet, while secretly exasperated and believing the first malignant report, concedes and tells me to "follow my heart". He wanted to make sure I had no unrealistic expectations; assured him I had none whatsoever. A true professional respecting his clients' crazy wishes, I must say! He'll do the lymph node biopsy and bone marrow aspirate (diagnostic tests for lymphoma), and will send the goodies to the onco vet's pathologist.
- Regular vet says good luck. We discussed having a necropsy done (morbid, I know) due to the very bizaare nature of this case that has got several experts scratching their heads. That'll nail it down for sure.
Scheduled the biopsy for Monday. All the vet techs and receptionists know my voice now, as they don't even wait for me to introduce myself over the phone! Sorry Bri, here we go again. Say goodbye to one of your lymph nodes.
In the midst of all this insanity, the most important question to ask is: How is Brian, nowadays, anyway? Mantra: Focus on the dog, not the cancer! He's okay, seems like we've hit a plateau for now. Lethargic, limpy, and will not eat boring ol' dry kibble unless it's completely wrapped in ricotta cheese. Though he was all-out begging for sausages last night. All in all, he's still alert and happy to be with his pack. Plenty of tail/butt wags and paw high-fives.
Wednesday, February 11, 2009
Left the house at 1045am, got there at 1230, walked the dogs a bit and waited for my 130 appointment. Lobby scene, from one parent to the next: "So, what type of cancer?" Valid question. It is an oncology center, after all. A yorkie and a spaniel both had nasal tumors, while the kitty next to us had breast cancer. I pretty much won the "worst prognosis/most painful illness" contest there.
Comet and Brian, having waited the longest at the reception area, decided that this was their turf and barked at every dog that walked in. "We'll give you your own room," offered the receptionist. Embarassed again by my noisy and highly exciteable dogs...
Met Dr.Rosen at 2pm. Like the entire staff, she was very warm and positive. I guess compassion is the #1 job requirement if you're employed in the cancer care business! That, or they're just all plain nice folks, you almost forget why you're there, they're so nice. I originally was scheduled for palliative radiation, per the advice of my regular vet and the oncologist in Norwalk, CT. but Dr.Rosen (a radiation oncologist) had doubts about that original diagnosis, and had doubts about the efficacy of radiation in this case, where the disease is so spread out. She didn't even use the "C" word. I liked how she was critical of previous reports, explained to me why exactly she was critical of them, and then tried to look at the case history with a fresh set of eyes. She won my trust and respect right then and there. She explained how the language in his bone biopsy pathology can be vague. In any case, she decided to do more non-invasive diagnostic tests by taking 5 lymph node aspirates. They also took an ultrasound of the liver and spleen, for which a belly-shaving was required. Histiocytic sarcoma (the Norwalk, CT onco's suspicion) typically affects the liver and spleen, and this ultrasound could serve as another diagnostic test, another piece of the puzzle. *sigh* A hairless tummy, yet another stark, visual reminder of his sickness. I rubbed his belly to say goodbye to the fur before they whisked him away for half an hour.
We were the last to leave the center at 5pm. Long day indeed.
Lymphoma!?! I don't even know what to think now! What about the disintegrating bone that was our focus from day one? Dr.Rosen gave me all the possible scenarios ranging from best to worst cases, also stressing that Brian's symptoms were truly far from classic.
Quick search for "canine lymphoma" yielded the following:
only one lymph node involved
several lymph nodes in the same general area involved
all peripheral lymph nodes involved
all peripheral lymph nodes plus the spleen, liver, and/or anterior mediastinum in the chest involved
bone marrow involvement, regardless of any other areas involved
I don't know - so confused at this point. Do I want to subject him to more procedures, or just follow the path of least resistance? Lymphoma can be responsive to specific chemo agents, potentially offering several months of remission. Provided that the diagnosis is not too late. And it can kill a dog within 4-8 weeks if left untreated. Brian's symptoms started with a 5-second limp way back in September. He should've been kaput 3 months ago, then.
Again, back to square one. What the heck is wrong with my dog?
I go home and discuss with hubby. After deliberating, we decide to keep pushing for answers. How can we arm ourselves with the proper tools, after all, if we don't know what it is we're fighting. The palliative treatment options (pain meds/chemo/radiation) would depend on exactly which type of cancer. Again, it's all about the quality of life, even if the length of remaining time stays the same.
Side note: Dogs do not suffer from adverse effects of chemo and radiation that humans typically do. No pain and suffering there, if we were to go that route.
I left messages with our surgeon-vet and regular vet to see what they thought of this new development, and will go from there. I feel like I ran a marathon. So exhausted.
Tuesday, February 10, 2009
A bit upset that I accidentally deleted a week's worth of doggy pics on my camera. Backed up on two drives, deleted the files on the camera, only to realize after the fact that some were not backed up. There were a couple of really good ones with Brian excitedly giving Sara the paw. Waaah! It's okay, I have "photos" captured in my head.
More on yesterday's road trip to NEVOG, later...
Friday, February 6, 2009
Asked the vet a couple of panic-stricken times if it was time, and she said "Oh God no, he's still got some fight in him."
Dr. Alice Villalobos' quality of life scale quantifies what I already intuitively know:
1) HURT: Adequate pain control, including breathing ability, is first and foremost on the scale. Is the pet’s pain successfully managed? Is oxygen neccesary?
2) HUNGER: Is the pet eating enough? Does hand feeding help? Does the patient require a feeding tube?
3) HYDRATION: Is the patient hydrated? For patients not drinking enough, use subcutaneous fluids once or twice daily to supplement fluid intake.
4) HYGIENE: The patient should be kept brushed and cleaned, particularly after elimination. Avoid pressure sores and keep all wounds clean.
5) HAPPINESS: Does the pet express joy and interest? Is he responsive to things around him (family, toys, etc.)? Is the pet depressed, lonely, anxious, bored or afraid? Can the pet's bed
be close to the family activities and not be isolated?
6) MOBILITY: Can the patient get up without assistance? Does the pet need human or mechanical help (e.g. a cart)? Does he feel like going for a walk? Is he having seizures or stumbling? (Some caregivers feel euthanasia is preferable to amputation, but an animal
who has limited mobility but is still alert and responsive can have a good quality of life as long as his caregivers are committed to helping him.)
7) MORE GOOD DAYS THAN BAD: When bad days outnumber good days, quality of life might be too compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware that the end is near. The decision needs to be made if the pet is suffering. If death comes peacefully and painlessly, that is OK.
Patients can be scored, with ten points being the highest score per number. 35 total points and lower, out of 70, is unacceptable.
Thankfully, Brian is still near-perfect! He'll let us know. For now, every minute counts. :)
Thursday, February 5, 2009
We're reaching a point where the other procedures and pain meds -- though they do help a whole lot -- cannot sufficiently keep up with the increasing bone pain. He's not as comfy as I would like him to be, at this stage of the unforgiving disease.
Scheduled him for radiation at the nearest center, at New England Veterinary Oncology Group (NEVOG) in Waltham, MA. Very highly recommended facility in the canine cancer community, two hour drive from where I live. Two weeks ago, I said that I wouldn't, for fear of radiation dermatitis, anxiety over more vet visits, more cons than pros, etc. Fast forward two weeks later, and I see that the limp is here to stay. No more limp-free days, no more denying. He starts to run after his brother in glee, then realizes it hurts and trots back to cower behind me. As if the cancer pain is some visible, physical entity in front of us that I can protect him from. Next to the horror of seeing pain in his eyes, that feeling of helplessness, as my pup leans against me for emotional comfort, is a close second.
The fact that he tries to run attests to his spirit. But, while the cancer whittles away at his bone, the pain whittles away at his spirit. I can accept the physical deterioration that will come with time, but I have to keep fighting with him, as he still wants to fight now. His tail and butt are still wagging and he still rolls around in the snow! And, he greeted me excitedly this morning as I awoke! Ah, the simple pleasures in life. :)
Amputation for improving the quality of life, even if it won't cure the cancer, is the gold standard. Fur-parents of 3-legged-beauties all tell me they have never regretted their decision, as it gave them their pups back, who, unlike humans, aren't socially or emotionally scarred by the procedure. They readjust their stance, and then move on quickly -- literally and figuratively -- never looking back. Boy, can we ever learn from them! One nice lady whose dog lived for only two weeks post-amp said that she would do it all over again, as those last two weeks were blissfully pain-free. Certainly, a wonderful memory to have. Also viewed their happy videos of amputee doggies playing fetch and running fast as cold, hard evidence. Would amputate in a heartbeat, if Brian was a candidate. Alas, he is not, due to the metastasis to other bones. And short of chopping the miserable right front leg off, radiation is the next best thing.
I love the BCD board. Another member sent me an email and threw me a lifeline:
"I just wanted to throw my two cents here - for what it's worth. I know how you feel. When __ was diagnosed, we were not able to amputate because she had lung mets. I started off with just pain medication, but as soon as we went to the oncologist I changed my whole plan. The radiation was a miracle for us. Of course it did not cure her cancer, but it did give me months more of time with her -- pain free months that I will always be grateful for. The first radiation therapy session honestly didn't show much improvement. So we tried one more and after the second one she was walking without a limp! I couldn't believe it. In all, she had 4 treatments. If you want to know more about it, please email me and we can talk further."
Definitely feeling more confident about our next step!
Fortunately, radiation, unlike most of our unexpected expenditures thus far, is covered by his slimeball of a pet insurance. But wouldn't hesitate one bit if it wasn't. (I can almost hear Suze Orman saying "Shame on you!")
Monday, February 2, 2009
Dr. Elliot uttered the most meaningful words I've heard since this whole thing started: "He's here to teach you a lesson about life." The only other person who said that to me was Ros, our wonderful Chem dept mother-figure (kinda creepy actually, since she walked in to check in on me just as I was typing her name. Probably shouldn't be updating blogs at work. lol).
It was good to see Brian up and about. He was very interested in his surroundings and was pulling on his leash. Checked out the birds and reptiles in the cage, said hi to a toddler, and sniffed up and down, left and right. I just had to laugh at the sight of him with a needle sticking out of his forehead, among other body parts. Seems to work, he definitely looked relaxed! Even the ever-so-skeptical hubby remarked the same later that night.
Will post pics later, of him as a pin cushion...
We took a 30 minute walk, which he enjoyed. Sniffed here and there, trotted alongside his brother. He ate chunks of chicken breast, but cares very little for his kibble and stinky sardines. As usual, Comet wolfs down what his brother won't eat.
Saturday, January 31, 2009
Still lethargic though. Perks up but lays down right after the burst of energy. His new spot is on the hardwood floor, in front of the TV or under the TV table. Strange.
The rollercoaster is so typical with this disease, and it's beyond exhausting. Blows me away how he was happily running around just 2-3 days ago (see video from Tuesday 01/27/09!). Gut tells me the end is near, not the 3 months that the vets thought. And we're starting to accept. He's still scoring high on the quality of life scale, yet he's sleeping all the time now.
We're leaving the house for a few hours tonight, and I am the one having separation anxiety.
Update: He started acting out like a puppy 30 minutes before we left. Came home to a half-chewed up spool of thread!
Friday, January 30, 2009
Cost me $400 but worth every penny! More like a bargain, at this point. I'll move heaven and earth just to try to keep him comfy, 'til he's ready. He cried like a baby seal once he was locked up though, which just broke my heart. Did NOT want to leave the vet's office...
This morning he was lying so still, I practically had to nudge him to make sure he was alive. Morbid, I know. It's just that in the days of old, he would be all over me, nose-to-nose as soon as I opened my eyes, and not getting that greeting is strange for me. But at 4pm when I picked him up today, he was still crying like an abandoned seal, and pulling the vet tech along with him! At least he had energy, woohoo!
This poor guy, he really hates the vets. Comet, on the otherhand, loves loves loves it. Understandably so. Healthy brother doesn't get pricked or poked at, and gets lots of pats and cookie bones there.
Hopefully this IV pamidronate buys us some quality time. I'm hoping that he's just tired today (from the 8 hours of barking), and will perk up a bit tomorrow.
Thursday, January 29, 2009
Unfortunately, his pain this morning was the worst I've ever seen since this whole ordeal started. He woke me up at 3am, sitting tall beside me on the bed, just hovering over and staring at me intently. Weird. He does love to say hi, but not in the middle of the night. He also had his "Hi Mom, I've got something to tell you" look on. His are very expressive eyes and ears, which I am very attuned to. I can read his mind, read his emotions, just by looking at his face. He tries to snuggle, but tosses and turns, tosses and turns. Jumps off the bed, plops on the floor, stands up, gets on the bed. Repeat 10x.
I let him out, and rather than sniff around excitedly, he just runs out and then plops down on the snow to rest. Very unusual, very alarming. Not to mention, I could feel muscle spasms on his bad leg, and he was totally non-weight-bearing on it. Would trot on it, but would lift it up in the air while on a sit or stand.
The highs are really high, and the lows, well...
Off to the vet we go again, as soon as they opened. Took x-rays to make sure it wasn't a fracture. I was convinced it was, based on his utter restlessness and ocassional groaning. (It wasn't) Asked the vet if it was time, since I was in panic mode over these behavioral changes. This is not the dog I know. She said "not yet, he's still got a lot of life in him" True. He did follow me around all morning inspite of the pain. Though that could be because he sticks by me when he's frightened (e.g. loud, scary noises make him scurry towards his mom/dad, very endearing...). And, he did wag his tail as usual, and ate his breakfast heartily.
So, we're on a wait-and-see approach again. Added gabapentin to his list of pain meds. The pharmacist asked me if the meds were for seizures. Interesting - must be good stuff! I'll see what happens after the intravenous pamidronate tomorrow and the acupuncture on Monday.
Seeing him in pain is really the hardest. And I know it's not going to get better from this point onwards. I was prepared to hear the worst from the vet, would have been relieved almost, to tell you the truth. But she seemed to think it was just a bump in the road. I trust her completely. Though she did say to start bracing myself.
Wednesday, January 28, 2009
...with emphasis on LAZY, indeed.
Snuggling is his sport, as you can see. He never leaves Comet's side, though Comet is perpetually annoyed in an older brother "leave me alone" type of way.
I'm a germophobe and actually trained my dogs for years to stay off furniture. Owned motion sensors that beeped and shrieked whenever they tried to get on the couch while we were out. I'm happy to report that my standards have been lowered overnight. :)
And I just had to throw this one in (taken 04/24/07). Goofball in all of his glory. -->
Tuesday, January 27, 2009
And just this morning, he was all poopy and limpy with fever.
Okay, so perhaps his lymph nodes aren't swollen right now, hence no fever and no aches. Sometimes I wish that this is all a practical joke, that someone switched some other dog's X-rays and pathology results with Brian's. He sure doesn't look like he's got a terminal illness right now.
Can't complain though -- this is good!
Velcro dog still follows us around inspite of the pain. We figured, we could help a bit by sleeping downstairs. So, last night, down the stairs the queen-sized mattress went...
Ok, so this house has officially gone to the dogs. But, who am I kidding. That happened a looong time ago. ;)
Question: where am I going to sleep? -->
But then I pick up a tennis ball this morning and his eyes light up and focus intensely, body tenses in preparation for flight, and tail waps waps waps against the wall. I swear to God, the limp magically disappears when his adrenaline is rushing. For ten minutes, he was back to his old self, naughty ears perked up, pouncing on the ball as if it was a mouse and he, a kitty. And then he proceeds to taunt the fetch-obsessed Comet with "haha, I have the ball and you don't, so chase me"... and Comet proceeds to give chase. The neighbors probably think I'm a little too amused by this seemingly normal display of dog-roughhousing, as I laugh out loud and applaud this game of grab-ass, out in the snowy backyard. (Unfortunately, it always ends with Comet... uh... asserting his dominance.)
I was asking the vets about limiting his movement, as fractures are a real concern with this disease. If he gets one, it's all over, since the bone can't heal anymore.
I loved the vets' response though: "Just let him have his last hurrah, for cryin' out loud." I agree!
Did a bunch of research - many, many thanks to the wonderful and supportive fur-parents in the bonecancerdogs yahoogroup! All the vets never mentioned the role of a proper diet, probably because they thought it was a lost cause in Brian's case. But the BCD group always tells me never to give up hope, and I love them for that. At the very least, it will provide this pup's body with the right tools to fight for as long as he can.
Anyhoo, came up with the following.
Innova EVO Ancestral diet, grain-free
1 microwaved egg or 1 can of sardines per feeding
any other protein sources like left-over chicken breast, etc.
-->makes for one jealous Comet, that's for sure!
Supplements stuffed and hidden in blobs of ricotta or cottage cheese (works like a charm):
Fish Oil - 4 x 1200 mg in the am, 3 x 1200 mg in the pm
Vitamin A - 8000 IUs per day
Vitamin B complex -
Vitamin C -
Vitamin E -
L-Arginine - 1 in the am, 1 in the pm
L-Glutamine - 1 in the am, 1 in the pm
(Will grab all the bottles from the kitchen later, I forget the exact doses...)
+ Kaopectate for the occasional GI distress brought about by the onslaught of supplements.
Tramadol - 75 mg in the am, 75 mg in the pm
Deramaxx - 50 mg in the am
Intravenous pamidronate this Friday
Acupuncture (starting next week) - don't laugh, this comes highly recommended by respectable vets! Will find out next Monday if it helps.
+ lots of TLC! :)
I'm meeting the acupuncturist, sort-of holistic vet this Monday, and will get more input on the supplements.
Monday, January 26, 2009
Brian is "Bruiser". We thought he was going to be a pretty golden retriever like his momma.
Vet: (Looking at the 15lbs of fur before her) He's not a golden.
Me: Are you sure? The mom was.
Vet: This is not a golden retriever. Looks more like a lab.
Me: (thinking: "Whatever. Mom's a golden.")
Sure enough, he grew into a yellow lab, 80 pounds of pure muscle.
He's the one with the largest headshot on the site -- my superstar! LOL
He loves attacking Andrea as she enters the door... he satisfied his mouthing urges, in utter excitement over the visitor's arrival, by grabbing a coffee cup out of the trash today to offer to her! Crazy goof.
A special shout-out also to Mi Kyung and our tennis ball-throwing tea/coffee breaks back in 2007/2008, in the halls of Hall-Atwater in the middle of the night! Much to the chagrin of students who were afraid of big dogs saying hi to them out of nowhere. lol
<-- This is his "Mom, don't leave me, I'll stay as close to you as possible" look. On our way to the vet. Meanwhile, Comet's all nonchalant, thinking "Oh, grow up." lol
I've noticed in the past two days that discomfort, perhaps from the dull pain in the bones, makes him toss and turn a lot at night. Back when he was "normal", he would jump (pun intended) at every opportunity to snuggle with us. Nowadays, the cushiness of the couch and bed bothers him, and he prefers to sleep on the cold, hard floor. Cancer, one point, Barnes Family, zero. And he woke up with a fever and noticeable limp today. His physical well-being, or lack thereof, affects my mood for the day. Definitely not a high point on this roller coaster ride.
Met the vet this morning to get more pain meds and to assess their efficacy in keeping him as comfortable as possible. She thinks he's still fine, for now, given that his appetite is still gargantuan, and that he still chases balls, etc. But she thinks he is more 3 months out, rather than 6. Tears flow, but I don't care, because she understands my frustration 200%. I was kind of embarrassed and glad at the same time to see that he gained five pounds in a few weeks. He does have a special diet and several supplements, which, though balanced, I overfeed him with. Can't bear his "I'm still soooo hungry" look, a labby trait which I am currently grateful for, what can I do. Our spoiled rotten baby. The diet is low on carbs, supposedly to starve the cancer cells. Pardon my language, but... f*ck you, cancer!
Discussed his "last rites" with the vet too. Very surreal. When to decide (signs of dwindling quality of life), who to bring (us + fur-brother, Comet), what to bring (dog bed, toys), what to expect (sedation + injection). It helps that I feel very comfortable with her. She is compassionate and is very affected by our personal tragedy as well, as if it was her dog.
I'm getting better though. I no longer spontaneously burst into tears in public... at least not as much as I used to. I can now talk to my neighbor outside, a co-dog-lover, without having a meltdown.
Acceptance is coming, albeit ever so slowly. Brian will let us know when it is time, I am sure of it.
Friday, January 23, 2009
Our second "child", Brian was the product of an internet search for "rescue" and "golden retriever puppy", leading me to the site for an Irish Setter rescue group. This group, though breed-specific, happened to rescue a gorgeous and very pregnant golden retriever in Tennessee.
A couple of months later, the preggy mom gave birth to a litter of furballs cute enough to be on the cover of an L.L. Bean catalogue. Eight weeks after that, two of them, "Bruiser" and "Chubbs", were on a Delta flight to Connecticut. One went to a co-worker, the other to us. Bruiser was promptly renamed "Brian", after the character in our favorite cartoon "Family Guy" and/or "Brian Boru", the fearless Irish King. Something about the way he physically and verbally attacked makeshift barriers ten times his height and size, in our lame attempt to cordon off a playpen area in our then tiny apartment, made him look fearless indeed.
I'd have to admit, our first few months with Brian weren't easy. He had severe separation anxiety, and destroyed the house while we were away. Just when we thought that the whole house was puppy-proofed and all remaining items practically nailed to the floor, we would still be greeted by rampage and destruction. This coupled with Brian's pitifully ashamed "sorry mom and dad, I just couldn't help it" look. We were definitely spoiled by the angelic older brother, Comet, who did not destroy a thing post-teething.
Then, a slew of medical issues: Brian got mange, requiring several chemical dips for treatment. He also developed entropic eyelids, requiring a couple of surgeries. At which point my spouse was almost tempted to mail this dog back to Tennessee.
Sept '07: After 3 weeks at an out-of-country conference, I came back and found Brian and Mark inseparable. I guess they just needed some man-to-k9 bonding time!
Month by month our exuberant and energetic pup eventually mellowed out into the super-affectionate and happy dog that he is today, still goofy in an entertaining way.
11/13/08 - Tests for hip dysplasia come back negative.
11/--/08 - Limping shows up again, this time with slight fever, this time on front leg. First test for lyme disease comes back negative, pain meds again.
12/--/08 - Limp goes away.
12/09/08 - Limp comes back, vet visit, more pain meds.
12/18/08 - Proceed with vaccinations, business as usual. Apparently, vaccinating a dog with cancer is very bad, like "pouring gasoline over fire" (we didn't know back then).
12/22/08 - Brian and Comet scheduled for a day of doggy day care. 8am Brian greets me non-weight-bearing on right front leg. Panic ensues. Cancel doggy day care.
12/22/08 - radiograph, complete blood count, chemistry profile, immune and tick panels, pain meds. Diagnosis: negative for lyme disease (second test!) and any other immune-mediated diseases. Refered to a specialist (uh-oh).
12/26/08 - radiograph (2 views). Shows "unusual bone density", whatever that means .
12/29/08 - radiograph before bone and muscle biopsies and joint cytology. Phone rings. "Hi, it's Dr. Berzon. I'm cancelling the muscle biopsy; it's the bone. I see bony lesions, and that's not good." I do a google search for "bony lesions" and finally realize that my vet was trying to drop the "C" word without doing so.
01/06/09 - sutures removed, aspirate/cytology for possible fungal disease, negative for that
01/09/09 - results from pathologist, finally, and inconclusive at that. Shows no suspicious growth. What the *&^% is wrong with my dog! Vet, however, is still suspicious based on radiographs. Suggests a second, more invasive, bone biopsy.
01/12/09 - Fever, swollen lymph nodes, no appetite. Vet visit again. Little blips on the chest xray, possible metastasis to lungs. Bony lesions and lysis' alarming spread since 12/26/08 radiographs.
01/14/09 - Second bone biopsy, larger core taken out. Painful procedure, poor guy practically hallucinating from anesthetic drugs when I picked him up.
01/16-18/09 - In-laws visit with Rocket. Lots of romping in the yard. Brian is 100% perky, no limp. They wouldn't have thought he was sick had we not told them, and if not for the sutures of the biopsy!
01/19/09 - Pathology report comes back. Absence of bacterial or fungal causes, malignant cells definitively confirmed. Most likely osteosarcoma. Prognosis: 3-6 months.
01/22/09 - Visit to a vet oncologist for a second opinion. Chest xrays (3 views) confirmed lung metastasis. Discussed radiation (in Waltham, MA) and chemotherapy (in Norwalk, CT) options for palliative measures. Probably histiocytic sarcoma and not osteogenic sarcoma as initially diagnosed. Doesn't matter, still 3 months.
01/23/09 - Sutures removed at vet-surgeon. Discouraged from radiation and chemo as Brian is not a good candidate, due to diffuse character of cancerous cells (these procedures work best for localized tumors). Phone call from onco-vet confirms spread of bony lesions to ribs.
01/30/09 - Scheduled intravenous pamidronate session for pain management.
02/02/09 - Scheduled visit with acupuncturist for pain management, and also to discuss herbal supplements.
Inspite of all this, Brian is still playing grab-ass with Comet (their favorite game), eating like a horse, and lovin' like a lover! Here he is playing in the snow, with perked-up ears indicating mischief, 01/19/09 -->
There is something utterly disturbing and hopeless about watching a loved one who is young and high on life (canine, in this case) die a long, drawn-out death. A million thoughts swirl in our heads. What the...? How? And -- let me indulge in self-pity for a bit -- Why us? To quote a few of my faves,
Mom: "how on earth did he contract this rare disease!"
Vet: "Luck of the draw."
Vet-oncologist: "Cancer does what it wants to do."
I am documenting our journey so as to a) keep him alive in my heart and mind for years to come, remembering who he is and not what he has, b) help me accept and heal, no matter how slowly, c) keep Brian's human friends posted on his developments, d) potentially help other dog-owners who may, unfortunately, tread the same path, and e) keep this medical journal for tracking our baby's fight against this horrid disease. To quote my vet, "many cancers are treatable", but treatment options, in Brian's case, is "palliative", that is, for merely easing pain as we face what is imminent.
Dog-lovers and friends of Brian, keep sending him positive vibes.