I had been noticing a bit of stiffness in Tsuki's walking. I thought perhaps he had pulled something. I didn't do anything for a week or so but I could see swelling around the hock and it wasn't improving. I took him to the vet. While he is nearing 13 I didn't get the sense that it was neurological. I hoped that it was only arthritic, showing up only because we took him off the Prednizone (treating Inflammatory Bowel Disease).
My vet decided an ultrasound was in order. The report was not good The pathology report from the small sample taken was no better. I do like it that my vet gives me the actual reports, not just her digest of them.
Wednesday April 5, 2012
Dr. Siedlecki has a manner that does well for me. She is direct, honest, and calm. We discussed whether more ultrasound and another biopsy would provide us information that would influence the treatment plan. While Tsuki is a tough stoic dog I said I do not plan on doing invasive treatments such as surgery or amputation. With his age and physical condition I don't feel he gets a benefit from something that creates significant impairment. Dr. Siedlecki made it clear that no treatment plan was going to be curative, but some might relieve the pain and discomfort enough to provide better quality of life. Getting more information on the exact nature of the mass would help us identify the most effective plan.
Tsuki has already been through two major surgeries. One for mast cell tumor in 2006. Last year he had his spleen removed when we discovered a mass on it. That one fortunately was non-cancerous but did reveal his inflammatory bowel disease and some liver damage.
I left him for an ultrasound guided biopsy, and X-rays to check for evidence of spreading to the lungs. I'm now waiting for those results.
When I picked him up they had given him some pain killer - Tramadol. Apparently he thought that made him super dog and he tried jumping into the van. I was completely unprepared as I've been helping him in quite often. Unfortunately his leg didn't have the strength and he kind of crashed. I don't think he did himself any additional damage.
His leg is stiff and he has trouble getting up from lying down. That has not changed his opinion that he should get a walk at least once a day. So I have let him have a few ultra short walks. His attitude is great. I hope we can keep him comfortable for a good long while.
I'm just waiting.
Friday April 6, 2012
Had a conversation this morning with Dr Gabi Strottner Tsuki's results have come in and the diagnosis is hemangiosarcoma. This is the same cancer that took Tanith. Most often hemangiosarcoma starts in the spleen, although other locations, are not unusual. In this case he has one mass entwined in the muscles of his leg, and a second mass between the muscles of his abdomen.
There is no hope of cure. We can hope for something like two to six months of acceptable quality of life with chemo. I know that some people say they would never consider chemotherapy because in people the side effects affect quality of life. In people the dosing is intended to cure. In dogs the goal is "palliative." In other words the goal is to maintain quality of life by causing the tumor to shrink, to spread less rapidly etc. If the dog reacts poorly to the drug you stop, because the whole point is to make the dog feel better, not worse.
It is not heartless to consider the issue of cost. For many people even if they can literally afford the cost they don't believe the expense is worth the small amount of time bought. I understand that. Choosing not to undertake the expense is not evidence that someone doesn't love their dog enough. We have to balance everything and cost is one.
I question my own choice to go ahead with treatment exactly because it is very costly. So why am I doing it? First, my pets are my only dependents. Second, I still have another ten years to retirement. So I have time to make it up. Yes, I'd prefer to retire early but given the third reason I'm willing to make the sacrifice. The third reason is that this dog is still very very full of life. His leg hurts, he has trouble walking on it, yet he is not just curled up feeling sorry for himself. We took a walk around the block because he did his "you haven't taken me for a walk" barking. I'm having to order him to wait and allow me to guide him up and down the stairs.
Monday we start with radiation and chemo. I'm just going to keep an eye on his attitude and feel my way from there.
Monday 9 April, 2012
Tsuki came out of treatment feeling just fine. He recovered well from the anesthesia. They sent us home with some medication for nausea and diarrhea "if needed". Tsuki didn't want to get in the car right away so we took a short walk.
Tuesday 10 April, 2012
Is it my imagination or is Tsuki walking easier? I watched him go down the stairs and I didn't cringe thinking it looked more like a controlled fall. Other than his stiff leg and limp everything seems normal.
Wednesday 11 April, 2012
His leg is definitely feeling better. He broke into a trot several times on our walk.
Thursday 12 April, 2012
I'm very frustrated. Although Tsuki's leg is obviously feeling better he is not feeling better. He had a normal bowel movement, but he doesn't want to eat. I tried the medication, no improvement. His temperature is normal, his gums and capillary refill are normal. He is drinking a bit more than normal. He didn't want to turn around and come home when we walked. Still he looks miserable. A second dose of the medication also didn't help.
Friday 13 April, 2012
It was a reasonable try but this is no good. I can't trade one bad thing for another. While Tanith and Cindy tolerated Chemotherapy very well it is not to be with Tsuki. This evening I gave him the only gift I could. He can stop being the tough dog now and sleep in peace. That'll do Tsuki. DogPlay's Shoot the Moon retires.
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