Yesterday was Hoover’s birthday and we gave him treats.
I get up to take a shower and let her know she can come to the bathroom with me if she needs to know what letter comes next. I expect her to bring her paper and pen and camp out with me while I shower.
In four-year-old style, she runs to the bathroom to ask me what comes after ‘V,’ then runs back to the dining room to write the letter, then runs back to the bathroom to ask what comes after ‘E.” And so on.
The night before Hoover had turned 8 years old. It was also the night we saw the tumor on his leg. In fact, my neighbor showed me the tumor and then several hours later I actually remembered it was his birthday: January 30th.
He had been limping for about a week and after a few days I realized it probably wasn’t a sprain, since it wasn’t going away. I examined his paws and concluded that his toenails were too long.
Somehow I missed seeing the huge swelling on his left wrist.
I’m staying home with Nora who appears to have pink eye. I get out of the shower and begin researching online and catastrophizing. I type in search phrases such as “dog leg tumor,” “hard swelling leg dog” and “dog cancer limbs.”
I soon discover a type of cancer called Osteosarcoma. It is most common in large breeds and frequently occurs in the limbs. It metastasizes quickly and often spreads to the lungs first. Even dogs that don’t show any tumors on the lungs at diagnosis often have it on their lungs, it’s just too small to see.
The standard treatment these days is amputation of the limb and follow up chemotherapy. The best outcomes happen for dogs whose lung x-ray is clear. And the best outcome is to live another two years after diagnosis. Which feels like a nice long time if measured in tennis balls retrieved, liver treats consumed and naps by the wood-stove.
Osteosarcoma is very painful. Part of the reason amputation is indicated is to stop the pain associated with a bone that is slowly exploding.
Another bit of research tells me that dogs don’t give a shit if they only have three legs, as long as they’re not in pain. It’s people who get squirmy at the idea of amputation.
I watch inspirational videos of “tripod” dogs enthusiastically catching frisbees and swimming.
We see the Vet on Tuesday evening. She is “worried about how firm” the swelling is. I tell her I know what it could be. The x-ray confirms our fears.
A second x-ray tells us that his lungs are clear. The Vet says there happens to be a radiologist in that day who was able to review the pictures. Which means he probably has a bit of cancer there, but it is still too small to show up on an x-ray. Still, I take this as good news. Treatment has a chance of working.
We leave with pain medication and a promise that the office will call tomorrow to provide and estimate and a time slot for the amputation, the sooner the better, we agreed.
When Hoover and I get home, Ben and Nora meet us outside and we all cry. I have been sending text updates throughout the visit and called with the bad news after the first x-ray. We get in the house and after giving Hoover a dose of pain medication wrapped in turkey, I do my best to explain to Nora what is happening. Hoover’s limp is because there is bad thing growing in his body and we need to get it out of there so he can feel better and be healthy. He will have a surgery to cut out the bad part and then we must take care of him until he feels better, which won’t take long. She is not bawling, which either means she doesn’t understand or she’s too scared to cry.
Being the pain in the ass that I am, I call the Vet’s office as soon as it opens at 7:30 the next day. The front desk tells me that I’ll get a phone call as soon the doctor who will do the surgery (not the same as the doctor who made the diagnosis) has a chance to get in and review the case.
By 12:30pm no call has come. I call again. I am able to schedule the surgery for next Tuesday (which is too far out in my opinion, given that dogs die in about a month without any treatment) but the Vet is still too busy to talk to me. I am not provided with an estimate. I am assured that the Vet will call me sometime today.
When I get home from work I schedule an appointment with a veterinary oncologist and then report to my friend Sandi’s house across the street. I tell Sandi and her husband Jim everything I know. Then Sandi pulls me into the other room to tell me that when she asked Nora about Hoover, Nora wouldn’t answer. Sandi asked her if she didn’t want to talk about it because it hurt too much and Nora nodded, a single tear trickling down her cheek. Sandi and I agree that Nora needs a good cry over this.
As we are crossing the street back to our house, Nora says, “Mommy, I’m not ready for Hoover to die.”
“I’m not ready either, Nora. We’re going to do everything we can to help him feel better. It’s very sad and I’m glad we can talk about it and help each other out.”
By seven o’clock no call has come from the Vet and I sit down to write an email. I praise the service I have received over the years but express concern that I have not heard anything yet.
Thursday morning as I walk from my car to my office I see I just missed a call from the Vet’s office. I call back immediately. The Vet asks if I listened to the message she left and I say no. She tells me that she reviewed Hoover’s chest x-ray and she believes he does in fact have visible tumors on his lungs. She says another doctor at the clinic agrees. She has sent the x-rays for a radiation referral and has not heard back yet which is why she didn’t call the day before. She advises me that if the cancer is visible on his lungs, she would not put Hoover through a major surgery.
I am devasted. I stand on the sidewalk sobbing and finally scurry into my building. Tear soaked, I ride the elevator to my floor and flee to a conference room to call Ben.
We both cry. We know we cannot put Hoover through all of this for nothing. If it’s too late, it’s too late. A thoughtful co-worker opens the door long enough to place a box of tissues on the table.
I explain to my boss my new situation and she tells me to go home. I call the oncologist we were to see at two o’clock and get our appointment moved up to 11 o’clock, explaining my primary vet’s assessment of the chest x-ray.
I head back home and Sandi, my dear friend and neighbor and I cry for awhile. Hoover is delighted I’m there and follows me around constantly. I stroke him and cry. Then we all head to the doggie oncologist together.
The first thing the oncologist tells me is that she reviewed the x-rays again after I called and she disagrees with the primary vet’s assessment. She doesn’t believe the eight 1mm spots on the x-ray are tumors. She believes they are blood vessels. “The x-ray takes a 3 dimensional picture of the chest and then smashes all of the images together.” The spots in the picture correlate to blood vessels that flow through the lungs and are basically cross-sectional pictures of blood vessels. She wants to see what the radiologist comes back with just to be sure, but feels very comfortable moving forward with the assumption that any cancer in the lungs is still too small to see and therefore treatable.
God Bless the specialist, I think. (And I am agnostic.)
She also says a diagnosis of osteosarcoma is a best guess. A biopsy may be able to tell us for sure, but may not and it risks fracturing the compromised leg. The other types of cancer it could be are less aggressive. But in any case, the leg should come off. We talk about the option of chemotherapy post surgery if osteoscaroma is confirmed once the amputated leg is tested. I also readily agree to donate a sample of Hoover’s tumor to a Oregon Health Sciences University study that is using DNA analysis of dog osteosarcoma to help develop treatments for human children with the same disease. This helps assuage some of the guilt I feel over being lucky enough to live in the first world with enough money to buy chemotherapy for a dog when there are children in the world who are sick, starving and unvaccinated.
I tell the oncologist that I do not want to wait until Tuesday to amputate and she arranges for a surgical consult with the animal hospital where her clinic is located. In a few minutes, I have Hoover’s surgery booked for Friday (tomorrow!) and I am speaking to a veterinary surgeon so confident and reassuring that I would have little reservation about her operating on me.
They give me an estimate for the surgery and the chemo and the Vet tech walks me through every line item.
Hoover gets a thorough exam and some blood work. If the blood work comes back with an indication of other health problems, we will have to re-evaluate the surgery, but at this point I feel better now that we have a plan in place. I give Ben the good news by phone.
We head back home to enjoy the unseasonably sunny weather and Hoover’s last day on four legs. I can’t wait to get that fucking tumor off of him.
To be continued….