It’s OK to be angry- the topic I hate to revisit

It was the day after Christmas, which is how these things always seem to go. I looked at the x-ray on the monitor and smushed my lips together at what I saw. “That looks terrible,” I say to my friend Kristen, also a veterinarian. She nods glumly. A lytic, destructive bone lesion. Pretty cut and dried for cancer.

Survival statistics for cancer depend on a lot of things, but one of the main prognostic indicators is type of cancer. Bone cancers are notoriously nasty and challenging to treat. Typically, one would deal with a lesion like this- sitting right on the ankle bone- by amputation, a treatment that removes discomfort on the part of the pet but doesn’t increase survival time. So, it’s a palliative treatment. There aren’t a whole lot of options.

Kristen scratched the patient behind the ears. “I’m sorry, old girl,” she said.

And Koa licked her hand, like she always does.

So yes, that’s been our holiday, which is fast turning into my least favorite time of year. As you all know, Koa has been at my mother-in-law’s for a period of time, during which she has done very well. But it also means I didn’t see her ankle joint starting to swell. I noticed it right after she came home on Christmas, as she was walking in the backyard.

There are a lot of different reasons I assumed it was what it turned out to be, that “clinical intuition” in actuality a combination of physical exam, statistics, and experience. Sometimes things surprise you, but usually they don’t. The radiograph the next day confirmed it. Koa has a cancer lesion on her ankle, and it sucks.

With the exception of Taffy, my childhood Lhasa who expired of heart disease, all my dogs have died of cancer. Hemangiosarcoma, melanoma, lymphoma, and now what is most likely a synovial cell sarcoma. I’ve spent more time than I care to talk about at the local specialty hospital and I’ve done some pretty aggressive treatments, both radiation and chemotherapy. And this is what I’ve learned:

  • It’s OK to be angry, even if you kind of knew it was coming.
  • It never gets easier, no matter how many times you’ve gone through it.
  • You know your pet has a finite lifespan, but there is something about getting the diagnosis of a terminal condition that is just so final. The sense of dread when the stopwatch starts ticking is always there.
  • It’s OK to not do the most aggressive thing.

Suffice it to say, there are a lot of factors that go into deciding on an appropriate course of treatment for your pet. Their state of health, economics, effect on outcome, quality of life- all of that matters. And it’s your veterinarian’s job to help you make the best decision for yourself and your pet. That is what I want to stress to everyone, because I know so many of you have agonized over the same questions- you don’t have to do everything if it’s not the right thing for your family.

For a variety of reasons I spent a good deal of time thinking about, I have decided not to do a limb amputation on Kekoa. I’ll be as aggressive as I can with pain management and keep her quality of life good for a long as it makes sense. To be honest, were it not for the swelling I probably wouldn’t have noticed anything amiss- she’s as happy and active and prone to stealing rolls as always, and the only difference now is that I don’t get mad when she does it.

Today, she sneaked into the garage through a door normally just cracked open for Apollo.

 This was an unopened can of cat food. How she managed that, I’ll never know.

Then to top it off, she had cat litter for dessert.

Oh, Kekoa.

Cancer. Cancer sucks.

Filed: Blog, Cancer sucks, Health, Picks of the Litter Tagged: ,
  • http://twitter.com/Hecallsmekitten Hecallsmekitten

    I’m so sorry to hear this. Cancer sucks yet again! But good on Kekoa for not letting it slow her down!

    • http://www.pawcurious.com Dr. V

      Thank you! She is barrelling around like always, thank goodness. I’ll take it.

  • http://www.facebook.com/profile.php?id=1363015727 Michelle Cotton

    Awww, this really sucks. Hugs and prayers for Koa. I hope that the cancer is not aggressive and that she surprises you by sticking around for a long time, AND remains pain free. That last part is so important.
    My brother’s 10-year-old Golden has been battling cancer for over 3 months now. She’s lasted 1 month longer than they gave her so far. We all treasure every second she has.

    • http://www.pawcurious.com Dr. V

      The pain will be the big issue for us, if her cancer behaves like this type typically does.

  • http://coleemmett.blogspot.com/ Cole

    I’m so, so sorry to hear about this. Hugs to you and to Koa.

    • http://www.pawcurious.com Dr. V

      Thank you Sarah. I appreciate that.

  • Jessica Roberts

    I’m so sorry. We just lost our dog Cordy to cancer and I know how much that sucks. She sure will have a lot of fun and treats in the time she has left with you!

    • http://www.pawcurious.com Dr. V

      I’m sorry to hear about Cordy, Jessica. That sucks too. I hate this rotten disease.

  • Tabitha W

    As you know, we lost our Magoo just a few short months ago. I have always questioned if we did enough, or not enough or even let him go a little too soon. I am still making peace with this.

    Sending you and Koa lots of love. I hope she remains herself for as long as possible.

    • http://www.pawcurious.com Dr. V

      I’m not sure the question ever gets answered (with Mulan, for sure I had the same thing) but all you can do is tell yourself, I made what I believed was the best decision, and that is what matters. And believe it or not, that works after a while.

  • Rose D.

    Sitting here crying at work. I am so sorry.

    • http://www.pawcurious.com Dr. V

      Thank you Rose. And I’m sorry, I didn’t want to make you cry!

  • carolinegolon

    xo.

    • http://www.pawcurious.com Dr. V

      Thanks C.

  • http://www.facebook.com/LindaPCase Linda Case

    I am so sorry. Your statement “It never gets easier, no matter how many times you’ve gone through it” says it all.

    • http://www.pawcurious.com Dr. V

      I keep waiting for it to get more normalized, but it doesn’t.

  • Sue W.

    Oh, hell.

    • http://www.pawcurious.com Dr. V

      Pretty much sums it up!

  • Shelia Krueger

    So sorry to hear. :(

    • http://www.pawcurious.com Dr. V

      Thanks Shelia. I appreciate it.

  • Deborah Mendez

    Sucker punched, yet again. My heart goes out to you and Koa with the soulful eyes!

    • http://www.pawcurious.com Dr. V

      She’s been wearing her calming collar, but I think I should take out my mask since I’m the one who’s been concerned! She is happy as always.

  • Jenifer

    Cancer sucks. The amount of treatment you do (as you know) does not equal the amount of love you have for Koa. It’s a personal decision.

    I always have to think though, do they KNOW they have Cancer? Or does Koa just think “Something is up with my ankle. Hey, a can of cat food!” Take care~

    • http://www.pawcurious.com Dr. V

      She’s clueless. Which is how I like it. They don’t ponder mortality the way we stupid humans do, which frees them up to enjoy things a lot more.

  • kgseymour

    Oh, Jessica, I’m so sorry. My stomach is in a knot and my heart just HURTS for you. And I’m so angry that you and Koa and everybody involved has to go through this. Sending you all the strength I’ve got.

    • http://www.pawcurious.com Dr. V

      And you have a LOT of strength, so I appreciate that.

  • Karen B.

    So very sorry, Dr. V. It does suck. We lost one to hemangiosarcoma at the age of 5, another to pulmonary sarcoma at age 7. Horrible disease. Keeping you and your family in my thoughts.

    • http://www.pawcurious.com Dr. V

      Oh, no. How awful. Thank you for your thoughts.

  • http://twitter.com/mihaela_v Mihaela (Dr. V)

    oh, no. I am so sorry. Hugs to you and Koa.

    • http://www.pawcurious.com Dr. V

      Thanks Mihaela. Much appreciated.

  • Roxanne @ Champion of My Heart

    Oh, kid. I’m so sorry to hear the news. I’ll be mad / sad right along with you.

    • http://www.pawcurious.com Dr. V

      Thanks Roxanne. I seem to be a cancer magnet for dogs.

  • http://my-alternate-life.com/ Jordann

    So very sorry to hear that, there isn’t much to say except my heart goes out to you.

    • http://www.pawcurious.com Dr. V

      I appreciate it, Jordann. Thank you.

  • Kristin

    I am so sorry. Hugs for Koa and you.

    • http://www.pawcurious.com Dr. V

      Thanks Kristin.

  • Sherry in MT

    That’s okay Koa eat what you want! Okay so opening the cat food can probably wasn’t the best move! Your holiday was much like mine then, I put down one of my sweet dogs the day after Christmas. Sucks…..everything you noted I also noted over that weekend while we tried to keep her comfortable…..

    • http://www.pawcurious.com Dr. V

      I am so sorry, what an awful holiday for you. :(

  • Financial Black Sheep

    Spoil the Crap out of her. I am sure you already know that, but that was the only thing that brought be comfort when my lovely Samantha was put down this past summer. It happened so quick I didn’t get to take her home, but I knew in my heart I did everything I could for her and spoiling was at the top. Hugs and comfort being sent to both of you.

    • http://www.pawcurious.com Dr. V

      That was what I remembered most about my dogs who were sick, so you’re right- I need to focus on making them happy.

  • http://www.facebook.com/people/Tammy-Barker/1198646597 Tammy Barker

    I’m sorry Koa, you and your family have to go through this. Sending warm thoughts your way.

    • http://www.pawcurious.com Dr. V

      Thank you Tammy!

  • Annette

    So, so sorry to hear this. Big hugs to all!!

    • http://www.pawcurious.com Dr. V

      Thanks Annette! Hugs back.

  • Heather

    My hear is thinking of you and Kekoa.

    • Heather

      *heart

      • http://www.pawcurious.com Dr. V

        Aw, your heart AND your ear. :)

  • http://twitter.com/shivathedog Kristine

    I’m so sorry you’re having to deal with this once more but I am glad lovely Koa is still up to her usual tricks. I hope she keeps opening those cans for much longer than you expect! My heart goes out to you.

    • http://www.pawcurious.com Dr. V

      If determination is a prognostic indicator, she’s got a long way to go yet.

  • Michelle S

    Oh no! I’m so sorry!

    • http://www.pawcurious.com Dr. V

      Thank you Michelle.

  • Kim

    I’m so sorry, Dr. V.

    Your writing makes always makes me sniffle and smile at the same time. I love this: “To be honest, were it not for the swelling I probably wouldn’t have noticed anything amiss- she’s as happy and active and prone to stealing rolls as always, and the only difference now is that I don’t get mad when she does it.”

    As someone who volunteers at a shelter, Koa’s second (third? I forget…) chance with your family has always resonated with me. As we say at the shelter when a pet (especially a harder to place pet) goes home with a great family, Koa “hit the jackpot.” She has crammed — and will continue to cram — a lot of love into her life with you. (And if some of that love comes in the form practicing her cat food ninja skillz, more power to her!)

    • http://www.pawcurious.com Dr. V

      Oh, that is so very kind of you to say. Thank you.

  • Jenn D.

    I’m so, so sorry. Koa has a sweet little spot in my heart, and I hope to be reading about her antics for a long time. I recently lost a kitty to cancer and there really aren’t words as to how much it sucks. Kisses to Koa from me and my fur kids.

    • http://www.pawcurious.com Dr. V

      I’m sorry you lost your kitty as well. It sucks, a lot.

  • carol martin

    Thanks for reminding us of that sick feeling in the pit of the stomach that hits and you feel so guilty immediately for having it. For those days when all you feel when you think you see light at the end of the tunnel is that it may be a train coming… We all have ‘em and they are normal. Best to take our cues then from the dogs and live in the NOW, don’t borrow trouble. Just be the dog!

    • http://www.pawcurious.com Dr. V

      So true!

  • http://www.facebook.com/profile.php?id=1107338225 Jessi Jaffe

    There are no words. It is a testament to your writing and sharing with us that as I sat here reading, I was as heartbroken for you and your family as I am for the animals and their families that I have known through the office I work at.

    As Kim said, Koa hit the jackpot with you and yours. You might want to invest in a safe for Apollo’s food though – now she knows he eats the good stuff …

    • http://www.pawcurious.com Dr. V

      I know, right? I think I should put the cat food up higher now.

  • Natalie

    I can’t begin to imagine the pain, anger, and frustration you are feeling. Cancer sucks!

    • http://www.pawcurious.com Dr. V

      It does! Unfortunately.

  • http://www.facebook.com/profile.php?id=787191596 MySpyder Web

    #!#!#!##!!##!&^%((&^&%*&%*(*(**()))*(^%$%#$@#@#@#@#$#$!!!!!!
    So sorry! Been there! We lost our last Dane to sarcoma ( front right ankle). Hugs

    • http://www.pawcurious.com Dr. V

      Aw man, so you know. It sucks a lot.

  • http://www.facebook.com/profile.php?id=515136462 Heather Twomey

    F*@% cancer! I’ll be keeping Koa and you in my thoughts.

    • http://www.pawcurious.com Dr. V

      Thank you Heather.

  • Cleopawtra

    So sorry to hear Koa has cancer. My prayers and heart go out to you and your family as well as Koa. Spoil the heck out of her and make as many happy moments you can with the time you have with her. Hugs to everyone , but a a really big one to Koa.

    • http://www.pawcurious.com Dr. V

      Thank you- she’s getting so much love right now, I hope she can feel it.

  • Cathey

    Yes, Cancer SUCKS! I”m so sorry that you, your family and my friend Kekoa are having to deal with this. It makes me very sad to know that my friend will be gone sooner than I would like, but I know know you’ll give her the best life has to offer in love and affection and I hope you whisper in her ear once in a while that she has a friend in Iowa who also loves her.

    • http://www.pawcurious.com Dr. V

      I will definitely do that. :D

  • http://twitter.com/DawgBlogger jana rade

    Oh, Dr. V, so sorry! One can really easily learn to fear holidays because all disasters seem to happen just then. Brother-in-law had his dog fall ill on Christmas. First vet’s diagnosis was UTI. Dog did ok one day, terrible the next, which repeated constantly. At first, the meds were suspected. But the pattern remained off the meds too. Plus, what I was pointing out, this pattern was there before the vet visit. The vet himself admitted he had no clue what was going on, UTI was his best bet.

    I insisted on second opinion. Well, guess what? Mandy doesn’t have UTI at all (just a contaminated sample). What she did have was a splenic tumor. Taken out today, size of tennis ball. Apparently, a lot of nodules found all over the abdomen … Waiting for biopsy results but the new vet was already talking about chemo; does “smell” like hemangiosarcoma. From what I’m reading, the chemo doesn’t really do a whole lot in extending life…

    • http://www.pawcurious.com Dr. V

      Chemo for metastasized hemangiosarcoma? I wouldn’t. I didn’t, in fact, for Nuke. Bugger of a cancer.

  • http://www.thedailydogblog.com Julie Melfi

    :( I love that sweet face and that she is creative enough to open a can of cat food. She’s living life to the fullest :) I’m so sorry – big hugs to you and Koa.

    • http://www.pawcurious.com Dr. V

      She’s living large, that’s for sure! :D

  • monica

    I’m sorry. xoxoxo

    • http://www.pawcurious.com Dr. V

      Thank you Monica.

  • MizzBassie

    Oh no, I am so sorry about Koa. You are so right, it never gets easier (and would you want it to?) Your advice is great. thank you for this post. Purrrrrrrrrrrrrrs.

    • http://www.pawcurious.com Dr. V

      Purrs back- thank you!

  • Summer

    I firmly believe that “animal people” have this beacon out in the universe (like a Bat Signal, if you will) that lets animals know that we are there for them. That’s why injured cats show up on our doorsteps, and lost dogs run up to us on the beach- somehow they know we will help them. And “special needs” pets find their way to us because the universe had led them to the people who will love them and never give up, despite many a frustrating challenge!

    The universe brought Koa to you because of this. She has been blessed beyond words to finally get the love she deserves. I am so sorry to hear about her illness, and the pain your family will have to endure, but I am happy that she has shared such a joyful life with you.

    • http://www.pawcurious.com Dr. V

      Thank you so much Summer. Those are very kind words.

  • Phenny

    Oh HELL. xox

    • http://www.pawcurious.com Dr. V

      Yep. that was my response too.

  • Lisa W

    Oh Dr. V, I am so very, very sorry to see this news. I’m glad I’m working from home so that no one can see me cry. Much love to you and Koa.

  • Susan Montgomery

    So sorry to hear this! It’s never easy, no matter what it is that takes them from us. We finally had to let our beautiful cat Katana go in November. 16 years old, and until the last 2 weeks, never admitted she needed to slow down. They live in the now, and I have to think that is a good thing. They revel in the joy of live every moment. So nap in the sun, run and chase things, laugh, love, and eat the cat food whenever you can.

  • Val

    Love and hugs to Koa … and to you and your family.

  • JaneK

    Oh, Dr. V… I am so sorry. I couldn’t agree with you more on all those points. And they apply to the human loved ones in our lives as well. I had to put down a horse from cancer and my vet told me the same thing… it is ok, and sometimes the best thing, to not be aggressive….. I will cherish that conversation in my heart knowing he guided me to do what was the most dignified and compassionate thing for my sweet Fox. It sure doesn’t take the pain away. Thanks for sharing with us. My thoughts are with you….

  • Tonya Whetsel

    No. Just no!!! I am crying right now. I went through bone cancer with my once-in-a-lifetime dog, Shaq (also a black Lab). I did not choose amputation, and afterward my vet told me he would have made the same decision had Shaq been his dog. We did the radiation, diet change, pain mangement route, and I know how this story goes. I wish I could do something to change the end of it for you this time. My heart is with you and Koa as you travel this road (hopefully, for quite some time), and I’m sending the healthiest vibes possible her way. It doesn’t make it any easier knowing that others have walked the same road, but I hope it helps a little to know how much I truly do care. I agree with everyone else that you have given Koa the best years of her life so far, and that’s something cancer cannot take away.
    Love to you, Koa! And you eat all the cat food you want!

  • http://www.facebook.com/JenniferLynnAgnesBartlett Jenn Bartlett

    Going through this with one of my cats (was purring a little oddly) and when I took him into work (I’m an RVT), we found a 1″ x 2″ lesion in his lungs. We are doing the same you are – keeping him happy until the end. For us, it’s the right decision. Sorry to read about Koa.

  • Jen@MyBrownNewfies

    So sorry to read this about Koa. We’ll be thinking about you both and sending good thoughts and watching her eat her bucket list:)

  • Audrey B

    Reading this brought tears to my eyes and made me hug my cats a little bit tighter, even if they did pretend not to like it. My heart breaks hearing this sad news. The love an animal brings into your family’s life makes it all worthwhile though, doesn’t it?

  • http://profiles.google.com/jennyloutaylor Jennifer Taylor

    Aw, I’m so sorry, Jess!