Snuggled with us last night without tossing and turning. Greeted us when we awoke. Alert today. Ate most of his breakfast, though had to be coaxed. Perked up for bathroom breaks, barked at noises outside. Made a snow angel and didn't plop down on the snow, like he did on Wednesday and Thursday. Hints of playfulness here and there. Breathing normal. Really peaceful when laying down, pain is under control even without the tramadol, gabapentin or deramaxx. Limp hardly there. Wags his tail when petted. Hangs out with us rather than isolating himself. IV pamidronate did its job!

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!

Bisphosphonate session

Brian boy got his intravenous pamidronate today, administered over a period of 4 hours at the vet. Stabilizes the bone, inhibits cancerous growth, etc., for pain management of osteosarcoma.

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.

Cancer boy had a really good day yesterday - I came home to ripped up trash! And, he yanked the plastic rain gauge out of the snow-covered flowerbed, ran far away from me in an attempt to conceal the forbidden object, and started crunching on it in his old naught way. I never thought I'd say this, but - those antics really made my day!!! Heck, it made my month!!!

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.

Pics of our "lap" dogs on a lazy Sunday (01/25/09)

...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. -->

Yey

Update as of 01/27/09 pm: Brian is back! Temporarily, at least. What the heck - is it the meds? Greeting me at the door, barking like there's no tomorrow, making snow angels in the front yard, running through and in between pairs of legs, wiggling his butt and marching his hind legs while I rub his backside hello, limp ever-so-barely there, etc. etc. He even tore apart a random piece of paper today! Gone are the days when I would be horrified at such behavior. Now, naughty = feeling good. I rejoice at mischief, the world has gone mad! :)

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!

Slumber Par-teeh!

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? -->

Roller Coaster

Admittedly, we're having fewer and fewer good days. In the past week, sometimes I look at the poor baby and think, "Today is the day" or close enough.

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!

Low Carb Diet, etc.

No, not the Atkins diet, but one that is tailored for neoplastic patients. In a nutshell: Grains feed the cancer, while proteins and fats do not. Didn't realize how absolutely crucial it was to get the proper nutrition for these ailing immune systems!

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.

Food:
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 -
Selenium -
CoQ10 -
L-Arginine - 1 in the am, 1 in the pm
L-Glutamine - 1 in the am, 1 in the pm
Turmeric -

(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.

Pain Management:
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.

Rescue

Gosh, didn't realize the webpage that advertised Brian's litter was still up and running, from October 2006.

http://saveoursetters.com/HoneyAndPups.html

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

When the boss is away...

Boss man went to St. Marteen for a few days, and saw it as the perfect opportunity to bring the pups to school. Not that he would mind so much. But I just don't want to risk having to leave them both unattended in my lab, if the boss was around and if he calls me upstairs for impromptu meetings. The last time that happened, they went on a barking spree, out of boredom and lack of supervision, that flowed LOUDLY through the thin walls and corridors. Prompting several people from the department to ask me if my dogs were "okay", as soon as I returned to my lab. I guess they were barking bloody murder. Not the kind of noise you expect in the chemistry department, where dogs aren't allowed in the first place. Embarrassing.

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

Spoiled rotten

His momma's crazy-Nazi rules have gone out the window since his diagnosis: Brian now sleeps between his mom and dad, a feat unthinkable pre-Dx!

<-- 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.

"I've never met a dog named Brian before!"

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.

Noteworthy Dates Pre- and Post-Dx

11/--/08 - On and off limping with left hind leg. Possible soft tissue trauma from Brian being Brian. Shake it off approach, pain meds. Seems to work, limp goes away.
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 -->

When Life Throws You a Curveball

"For Christssakes, it's just a dog". Indeed, we are a young, childless as of yet, married couple, and those who know us well, know very well how our dogs are our family. They are the most faithful and loving of companions that make coming home from work, entering through the front door and being met by a circus of a greeting, the absolute highlight of our day.

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.