Friday, June 19, 2015

Latest Linden report

Linden, the Booger, my fourteen loyal readers will recall, is 16 years old, still loves to run, and looks like this:

Booger's had a malignant tumor on her wrist, and it's back for the 3rd time after 2 surgeries. Our vet said that he could not get clean margins, and it was fibrous and bad, and while it was unlikely to metastasize, it would always grow back, and worse each time. (It's a 'hemangiopericytoma' if anyone is curious.) Sure enough, it's back again, and he said that there was nothing he could do. This type of tumor does not respond well to chemo, and we wouldn't want to do anything to compromise Booger's quality of life even if it did. In time, it would grow so big (though without pain) that it would cut off the blood supply to her paw, and she'd be so uncomfy we'd have to put her to sleep at some point. He estimated about a year. At that point I burst into tears. He said, "You've taken wonderful care of this dog..." I then blubbered, "But look at her! She's like a puppy! She's not like other 16-year-old dogs!" He then said he'd make some calls to canine oncology experts and get their take on this.

A few days later, he called back. Apparently, radiation treatment is the only thing recommended for this type of tumor. The likelihood of success is high, and the side effects are low. The only catch is that we don't have it in Alaska. Booger would have to be sent to Washington state for a course of 3.5 weeks. Now that's a problem. We don't know what a month of Booger being in Washington will buy us in time and quality of life. A year from now, which is her projected life span WITH the tumor, Booger will be 17, which is already a good run for a dog. Hell, 16 is already a good run! But if she's still otherwise in great shape at 17 and I'd know that otherwise she'd have had yet another year without the tumor, I'd kick myself for not having taken this chance now...

DL and I noodled over this for a bit and decided that we would not do it. Part of it, I'll confess, is my own selfishness. A month without Booger would be like a month without sunshine. A month taken away that she could have spent hiking with us and eating cheese on the couch. But I hope that my interests are also aligned with Booger's. My friend and neighbor MR laid it out well for me. "What would Booger want if you could explain this all to her?" I answered immediately, "Booger would not want to leave us." So there you go.

The good Dr. F. did say that had she been younger, he'd recommend amputation. I wonder if, when the tumor has reached a certain point where we're looking at euthanasia, we might consider amputation as an alternative then instead? Booger would be a GREAT candidate to be a tripod dog. She's not a moper or a brooder. She's active and playful and lean, she has a high pain tolerance, and she's... not exactly the brightest bulb, so she'd probably forget pretty quickly where she had left that leg and be just fine! Dr. F. is out today, so we'll call him Monday and propose that to him.

In the meantime, he has agreed to attempt to remove what he can of the tumor one more time, which will be next Thursday, so please wish Linden a speedy recovery! And who knows? Maybe this time it won't grow back!

My mother has pointed out several times that she worries for the state of my health, since Alaska doesn't have, in general, as good quality of health care as the Lower 48. Here is a situation that illustrates that. Had we been living in my native Bay Area, I'm sure I could have taken Booger for inpatient radiation therapy at one of the many big vet hospitals there. But on the other hand, we don't know if Booger would have made it to 16 in the Bay Area, with the worse daily quality of life she'd have had there. She might have died at 15, which is already a good life span for a dog, and we'd have said, "Thank goodness for the great medical care in California! Booger made it to 15!" and we'd never have a cancer story. One just never knows!

I guess we are all dealt just the hand we are dealt. It's a privilege to be handed the most unusual dilemma of how to care for a 16-year-old dog that cannot be treated the same as other 16-year-old dogs because she is so healthy and active! Any other 16-year-old dog would be recommended for only palliative care, with no long-term horizon. With Autumn and Linden, I am still given lectures about minding their fang health and about limiting the bacon! :)


Sarah Foster said...

Oh so sorry. We lost a dog last year to bone cancer which had spread so amputation wasn't an option for him. I'm so glad you have options (although limited in Alaska) and are thinking about what your Booger would want. She is truly a beautiful and very special dog.

Allmycke said...

I know the pain...

gina said...

I'm sending healthy thoughts and supportive prayers. I had to make the decision to put down my cat and it was hard to do. I'm sure you'll do what's best for her and what she'd want done.

hans said...

Lots we can learn about human cancers from dog cancers... my 1st question would've been, 'is there a treatment for Linden that would advance the science?'

mdr said...

Best wishes for Linden's speedy recovery.

If I were a 16-year old dog, I wouldn't choose to lose a leg in exchange for living only slightly longer, maybe 16.5 year? maybe 17 year? NO!

Take care of yourself, only if you are well, you can take care of those you care.

bt said...

Sending good thoughts for a successful surgery.

Arvay said...

@Sarah, I'm sorry you had to go through that. Thank you for your kind words!

@Allmycke, I suppose all pet owners do at some point. Thank you for sharing yours with me and taking part of mine with you.

@gina, Thank you for the healthy thoughts and supportive prayers! They help a lot!

@hans, I agree that it would be great to contribute what we can do the body of knowledge. However, as a human being with a vulnerable heart that easily forms deep attachments, I cannot view my Booger dog as a mere instrument of science. Sending her to Washington probably *would* provide a great data point, as I'm sure treatment of a 16-year-old dog is rare. But I just do not want to do that.

@mdr, thank you for your best wishes! Regarding amputation, there is absolutely no need to make a decision now. By the time she is 17, we'll see if she's a good candidate for amputation, and what her quality of life would be like at that point.

@bt, thank you very much! I'll keep you posted on how it goes!