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Back on the Grid

Katie is now a . . .

OK. So a lot has transpired since we last posted.

Lola dear is still with us (more pics later).

Fort Funston Spring 2010

I am now working as a professional dog walker. I have been taking 2 packs of 6-8 dogs daily to Fort Funston and walking/hiking with them for 75 minutes. It is way more challenging than it sounds to the uninitiated. I have learned so much in a short period of time. Like how to drive all over the city, picking up dogs. How to park (legally and illegally) in a very dense urban area. How to get the pack to stick around. How to convince a recalcitrant dog that it really is time to go home. How to hold a Chuck-It and pick up poop simultaneously. How to use baby food and dog treats to the best advantage. It has been a wild ride and I love it. I have been leasing an old pick-up from the company I am contracting with. I have been rear-ended once(not my fault) and I high-centered the truck on a log (requiring a tow). But no traffic tickets so far. Some days are what I call 3P days: poop. pee and puke in the truck. Just goes with the job. Here some photos of the fabulous dogs I have gotten to know.

Morning Lookout

What's up?

Got mud?

Wait up guys

I love Lolly!

I could go on and on . . .

Home

It’s been a week since we brought Lola home from the hospital. Her radiographs from yesterday show that the gunk in her lungs has all but disappeared. Thankfully her goofy personality is back, complete with begging for food, following us around, grumbling at us if we mess with when she doesn’t want to be touched, and waiting for her Kong ball to be filled with peanut butter and treats. Her weight is still down, so we have been instructed to fortify her food with lean protein and good fats (fish oil, flax, etc.). We have always been relatively strict about measuring her kibble, feeding her only twice a day and avoiding people food. This is a new experience for everyone!

She is more tired than she used to be and she has adopted a new habit of getting on the couch and (dare I say it?) the bed.  I haven’t had a dog on my bed since undergrad when I borrowed my landlord’s Doberman after I had been followed home by some weirdo. Last night I went to bed early and Lola came in and jumped up. Then Naboo sauntered in and took his rightful feline place right on top of me. I think Lola must have had the good sense to get down before Dave came to bed, but maybe she just decided she wanted the couch instead.

We haven’t decided what course, if any, to take with her cancer. For now it is just good to have her back.

Putting out the fire …

Lola has had a really tough week. Like colossally, stupendously, unbelievably tough.

After having a splenectomy just before New Year’s Day, which led to a diagnosis of a particularly aggressive type of cancer (hemangiosarcoma), she started chemotherapy last Monday. The chemo is not an attempt to cure the cancer, which is not really curable in the sense that you normally think of. It’s an attempt to buy a few extra months on top of the normal 2-4 month life expectancy from this kind of cancer. Dogs typically don’t have the same difficulties with chemo that humans do, and we could afford it so we went ahead with the treatment.

Lola had about as bad as reaction to the chemo as a dog can have. Well, not immediately. The first few days were fine. But then on Thursday she started showing some of the lethargy that prompted Katie to take her to the vet back in December. By Friday morning I had to encourage her to eat breakfast and by Friday evening she refused to eat dinner, drink water, or even take treats from us.

Saturday we put her in the car and took her to the clinic where we’re doing the chemo to figure out if there was something else we should be doing to make her feel better. A phone call with Lola’s oncologist had raised the possibility that she was suffering from pancreatitis. They gave her a pain injection, an injection of anti-nausea medication, and some subcutaneous fluids to make up for her lack of intake in addition to checking for the pancreatitis. She did not have pancreatitis, but by late Saturday night she was not improving at all, and actually a little bit worse.

Lola with her tail wrapped for freshness.

Lola’s tail got wrapped in a bandage because her big fluffy tail was … well, since Lola wasn’t getting any solid food, she had diarrhea and … well … her tail was in the way. So, yeah. A big pink bandage to keep her tail out of the way.

So Sunday morning we went back to clinic and talked to the same vet that we saw on Saturday, who agreed with us that it was probably time to check Lola in for a day and night of professional care just to get her back on her feet and eating again. We weren’t thrilled with the idea of leaving her there, but there was nothing else we could do for her at home, so leave her we did.

We checked in one more time before going to bed and she was doing okay, although she had apparently started running a fever at some point in the afternoon. The fever was coming down by the time we checked in, but it had gotten up to 105° at one point (normal is 100° to 103-ish°). We had intended to go pick her up early on Monday morning, but the tech Katie talked to said to call before we came just to make sure she was ready. When we called this morning, Lola was doing somewhat better, but her oncologist wanted to check her before we came to get her, which as it turned out was a really good idea.

Because Lola had developed pneumonia. Yeah. Pneumonia.

So the oncologist thought it was best if Lola stayed at the clinic for one more night. Pneumonia notwithstanding, she was actually doing better today than she had over the weekend, which was good. Katie went to see her around lunch time and took her for a short walk and got a couple of tail wags out of her, and the clinic had managed to get her to eat a little baby food in addition to the intravenous fluids.

After I got off work we went back to the clinic with a smorgasbord of food Lola likes (chicken, sweet potato, pumpkin, cottage cheese, bacon) and a few things we’d never tried but seemed like they might get her attention (three stinky-sounding meat-based baby foods). She gave us some wags when she saw us and immediately nibbled just a little bit of chicken. Then Katie got out the cottage cheese and suddenly Lola was eating. Not wolfing like she normally would, mind you, but actively working on the container and happily eating. For the first time since Friday morning, two and a half days earlier, she was interested in food. Whew.

So she’s spending the night in the clinic again tonight, and we’re going to talk to the oncologist in the morning to see how we’re going to proceed, both with the pneumonia treatment and the chemo. Obviously we won’t be using the same chemo drug for her next treatment, if we even do another treatment.

It’s like we poured gasoline in the carburetor to get a stalled car started and set the engine on fire. We’ve just about got the stupid fire out so we can get back to the stupid stalled motor. I guess we should try push starting this time.

Storm Clouds

We knew chemo could have side effects. Look what it does to people, right? But dogs and cats are supposed to take it better than humans. So here is my dear, sweet Lola – my best friend for almost 12 years now – so nauseated that she won’t eat and so tired that she won’t walk.  What have we done? I look at the trusting face of this innocent creature and I just want to scream, “I’m sorry. Oh my god I am so, so sorry!” Have I betrayed her because I want her to live a few months longer? How could I be so selfish?

The doctor says this will abate. She is on anti-nausea medication that will hopefully kick in soon. Hope and longing are hovering nearby, ready to erode my fear and my helplessness. If only Lola would give them the cue. Hang in there, my little sweetie.

Lola the “Angel”

Lola just came home from her first chemotherapy treatment. She had an IV of Adriamycin, Dexamethasone and Benadryl. They sent us home with Anzamet to give prophylactically for nausea. No cannabis for the girlie!

All I can say for now is that she is the same old Lola: begging for treats and charming the staff. When I asked them how she did, they said “oh, she was just an angel.”

While I was waiting I met a guy whose dog is suffering from bladder cancer. He didn’t know that his dog had a problem until it’s bladder ruptured 4 miles out on a hike. He had to devise a make-shift stretcher to carry the dog back. What an ordeal. I feel lucky that nothing so dramatic has happened with Lola. I hope it stays that way.

All of the staff there are so kind. One charismatic guy, originally from Philly, calls Lola his “little bean”. Maybe he says that to all the girls. Plus, he calls me “Miss”.  Bonus points right there. He calls all the guys there “dude” and “my man”.   If Obama came in with Bo, that’s probably what he would call him, too.

Next treatment will be in 2 weeks!

The Ongoing Story of Lola

We met with the veterinary oncologist today to talk about Lola’s prognosis. There isn’t much change in what we already know about her condition, but there are some new details and some treatment options.

The (really) good news is that the tumor in her spleen was small and it does not appear that there is currently any more  malignant tissue. It also looks like this is what our oncologist refers to as a “low-level” hemangiosarcoma, not a “high-level” one. Those are not official designations, but in her experience there are hemangiosarcomas that are really fast and mean, and some that are not. A prognosis for a dog with a “high-level” sarcoma that was left untreated would be about two months. In Lola’s case that could be up to four months. With chemo, those numbers go up to six and eight. Add in some oral medication to help suppress the growth of blood vessels after the chemo is done  (which I guess also helps suppress the growth of the cancer, which is in the lining of the blood vessels) and there’s some reasonable hope that we could go past eight months. I’m personally putting my money on a year because I am an optimist by nature and because she’s a healthy, happy dog in all other respects.

The treatment is going to be expensive, but is within our means, if just barely. So of course we’re going to do it. Well, I say “of course”, but only because dogs response to chemo differently than humans (it’s less traumatic for them), and because this particular type of cancer will not cause Lola any acute pain. The chemo should keep her in pretty good shape for the majority of time that she has left, and when the cancer does finally start to win the race, it will basically sap her energy and slow her down more and more. I expect that we will get to the point where we decide to end it; when she’s just not getting enough out of thing. There’s a chance that she’ll go on her own, but we are prepared to make the decision if we have to.

But let’s not end on that note. Let’s on a high note. Lola is fully recovered from her splenectomy and running around like her goofy self. She’s been on low-activity for the last ten days, but as soon as we were done at the vet today we went for a walk at Fort Funston and had a great time. Right now she’s rolling around on her back wagging her tail boofing and woofing and trying to get us to pet her belly. At the moment things are really, really good.

And the good moments are what we’re living for now.

Lola’s impressive bandage.

What’s not obvious in this photo is that two of her legs got shaved (one for the IV, one for a post-surgical pain medication patch) and she looks kind of like a couple of ill-behaved seven-year-olds got caught in the middle of trying to give her a poodle cut.

Okay, the serious stuff.

Lola came through her surgery really well. She’s a very strong girl and we never really had any doubt that she’d do fine with the surgery. She was a little dopey from the fentanyl patch for a couple of days but still ready to go walking as soon as we’d let her, even with that big old stitched up opening in her belly. Now that she’s got the fentanyl patch off, she’s really ready to go and doesn’t understand why we’re still only walking around the block. Seriously. The looks we’re getting when we turn around and head back to the building are priceless.

The bad news is that one of the nodules was indeed malignant, and it’s hemangiosarcoma. Quoting from the linked page:

Hemangiosarcomas are a form of cancer which originates in the endothelium, which is the lining of blood vessels and spleen. As might be expected of a tumor arising in the blood system they are highly malignant and can be found almost anywhere in the body since blood vessels are necessary in almost all body tissues.

The upshot is that if you find hemangiosarcoma, there isn’t much you can do. It’s too aggressive and because it’s in the lining of the blood vessels, it spreads too easily. Removing Lola’s spleen may have gained us a couple of months, but even with chemotherapy, the cancer will overtake her before the end of this year, probably within nine months though it could be as soon as three months from now. Which seems both like forever and no time at all.

Next week we’ll be meeting with the oncologist to talk about treatment possibilities, but any treatment that we undertake will be to prolong Lola’s life a little bit, not to cure the cancer. So it has to be something that will not cause distress or make the final few months of her life more uncomfortable than the cancer itself. The oncologist said that basically Lola will just feel more and more tired until the end. Not that she won’t have any discomfort, but there won’t be any particularly acute pain, which is good.

Needless to say the last couple of days around here have been a little bit low-key and sad, but we are happy to have found the tumor when it was so small and to have gotten her spleen out so quickly. We’ve gotten ourselves a couple of extra months and at least it won’t be a shock when she does die. What we’re focusing on right now is making sure that we don’t start thinking of her or talking about her like she’s already gone, because she’s not. She’s sitting here right next to me staring at me wondering why I haven’t fed her yet and in an hour or two she’ll be following us around looking at the door and waiting for us to grab the leash.

It’s not particularly the way we wanted to start the year, but we’re going to make the best of it. Thanks for all the good thoughts.

David and Katie

Home



Home, originally uploaded by David McCreath.

At the vet



At the vet, originally uploaded by David McCreath.

For the last month or so, Lola has been a little lethargic on and off in a way that she hasn’t in the past — lagging a little on walks, showing some reluctance to even go on walks in the first place, not jumping up to greet us at the door a couple of times. So Katie took her to see the vet, and after some testing they found a couple of nodules on her spleen. So today we went to see a veterinary oncologist.

Current working theory is that at least one of the nodules periodically bleeds and while that doesn’t cause any pain for Lola, its effect is kind of like having anemia. When the thing is bleeding she’s losing blood and that makes her tired, then when it eventually clots and stops bleeding, her blood builds back up and she feels just dandy and frolicsome.

The nodules could be any one of three or four different kinds of tumors, and our options for figuring out whether they’re malignant or benign are either aspirating the nodules and testing that material or removing her spleen and doing a biopsy. The problem with the aspiration is that there’s a 30% chance of getting a false negative: she would have cancer and we wouldn’t know it. Since dogs can live without spleens just fine (our old German Shepherd had his spleen removed when he was 12 or 13 years old and lived another full year before a different cancer got him), we have decided to just go ahead and have her spleen removed. It’s obviously more invasive, and the recovery will take longer, but she’s so healthy otherwise that we decided she’s up to the challenge and want to make absolutely sure whether we’re dealing with something malignant or not.

We’re hoping to get her in for the surgery on Monday. Fingers crossed for many reasons.

Oh right. It’s winter.



Oh right. It’s winter., originally uploaded by David McCreath.

Extra layer and gloves today!