The "C" Word

“The relationship between a dog and a human is always complicated. 

The two know each other in a way nobody else quite understands, 

a connection shrouded in personal 

history, temperament, experience, instinct, and love.” 

Jon Katz, A Dog Year: Twelve Months, Four Dogs and Me

Cancer has got to be one of the scariest words in the dictionary. For even the most Zen person on the planet, the life-altering “C” word can send any semblance of tranquility packing. The thing about cancer is it is an equal opportunity disease. It strikes babies and old people, moms, dads and children, cats and dogs alike. I’ve had experience with cancer as a caregiver. I’ve sat with friends during chemo treatments. I've cried at cancer-caused funerals and jumped for joy with cancer survivors. I have not, however, had a beloved pet diagnosed with the life-threatening disease. Maizey is the first. I pray she is the last. 

 As much as I love my pets, I’ve never had a problem knowing when it was time to let them go. They were old, or sick or in extreme pain. Cancer is a whole new ball game. As with humans, cancer is not always a death sentence. It often comes with options not just euthanasia. 

Maizey is 5 years old. When she started limping, it never occurred to us that she might have a life threatening illness. John assumed she had pulled a muscle or sprained her ankle jumping off the bed. After a few days the limp disappeared. 

But it didn’t stay gone. After the third time, John took Maizey to the vet for X-rays. Doodle Dog isn’t one of those dogs that shivers and quakes in fear when she goes to the vet. She assumes the role of “queen” wherever she goes and Merrill Animal Clinic is no exception. She starts barking as she walks in the door to announce her arrival. She demands the royal treatment and she gets it. The girls in the office know to usher her straight to the back. 

John is on a first name basis with Dr. Rogaski, Maizey’s Primary Care vet.  “Cathy” checked Maizey over from paw to shoulder, from the tip of her ears to the tip of her tail. Agreeing with John’s jumping off the bed assessment, Dr. Rogaski sent Maizey home with some pain meds and instructions to rest. 

“Yeh, right!” thought Maizey as she pranced out of the office into her awaiting V8 powered carriage. The idea of rest was met with the same disdain as the suggestion she could stand to lose a few pounds. Maizey took that advice with a side of cookies. 

Assured Maizey's limp was "just" a sprain, we quit worrying about it. There was no cause for alarm when Dr. Rogaski called a few days later to check on her. We were not prepared to hear that the x-rays showed a shadow near Maizey’s shoulder joint. She needed to see a specialist. The specialist took more x-rays, then a biopsy. The diagnosis we least wanted to hear turned out to be Grade 3 Osteo-sarcoma. 

That’s the way with cancer, it creeps up on you. 

The first thing you do when you find out you or someone you love has cancer is cry. Then you rage. Then you go into warrior mode and research your options. 

“The clearer your mind and heart are, the easier you learn. The more you learn about cancer and how to treat it, the wiser the decisions you will make about your dog’s treatment. The calmer you are, the more likely your dog will be calm, too.” dogcancerbook.com (page 22)

As a caregiver I learned the importance of taking an extra pair of ears with me when going to the doctor for test results. When your beloved pet is the patient it's even more essential to have someone else with you to pay close attention to the details. Maizey may be able to hear a boom boom from several miles away, but she paid no attention to the man in green scrubs foretelling her future. While the doctor rambled on about treatment, and cure percentages, Maizey slept. I did my best to keep breathing. John stared at the gray blob on the light screen behind the doctor. We barely heard “let’s schedule the surgery for Thursday.”  

It makes no difference if you google it or seek multiple opinions. The prognosis for dogs with osteosarcoma is not good. The life expectancy is low, the cost high and quality of life somewhere in the middle. 

“Osteosarcomas are highly aggressive tumors, characterized by painful local bone destruction and distant metastasis (spread to other organs) http://www.csuanimalcancercenter.org/assets/files/Osteosarcoma.pdf

The most often suggested treatment for Maizey included, without delay:

• Amputate the leg to remove the primary tumor and source of pain. (According to the people we talked to, amputation is almost always well-tolerated by the patient. “Dogs with 3 legs can do virtually everything that 4-legged dogs can do."dogcancerbook.com ) 
•  Follow up with chemo. ("Chemotherapy is unlikely to cure most dogs with osteosarcoma, but can prolong a good quality survival. Most dogs tolerate chemotherapy well, with some dogs experiencing mild, self-limiting side effects such as depressed appetite, nausea, occasional vomiting and diarrhea for a few days. Less than 5% of dogs will experience severe side effects requiring hospitalization."dogcancerbook.com ) 
• While  euthanasia is the least desired option it must be factored into the quality vs quantity of life equation.

The most often suggested prognoses:

• Do nothing - 3 months. 
• Amputation alone - 8 months. 
• Chemo - possible year, 2 at the most

I didn’t envy John’s choices. He’s the only one who knows Maizey’s idiosyncrasies.  He alone knows the state of his bank account. Maizey is depending on him. There is no easy answer. 

From a human point of view, the world began to spin like an unbalanced washing machine. But when you look at this dog, it's hard to imagine there's anything wrong with her. For now she continues to do the things a middle aged dog is supposed to do -- swim, chase cats, dine on cat poop, bark at the mailman, catch balls, take naps and demand the attention she is convinced she deserves.