Healing Begins

It’s been 10 days since Miss Daisy’s surgery and she’s improving, albeit slowly.   We had her in a corral which she didn’t protest, but now I’m giving her a little more room. She spends most of the day in the yard alternating between the sun and the shade.  The last few nights we’ve allowed her to sleep on the bed, but I was up at some early hour helping her off the bed!  She just looked so disappointed when she couldn’t figure out how to jump up on the bed, nor did we want her to, so we hauled her up there.  I’m so used to her being between us, I don’t even mind when she leans on me, and it was reassuring to feel her warm body alongside mine.

I am concerned in that hopping around seems to tire her easily or cause her good front leg discomfort, although some of her behavior sounds consistent with anxiety caused by the pain meds. She stands up for a few minutes, then sits down right where she was sleeping before as though she’s just too tired to take another hop.  I know she has to gain some strength in that arm and lose a little weight as well, but it’s hard to watch her struggle.  I have to remind myself that she had MAJOR surgery, and it will take time to heal and start feeling like herself.  Today is technically the last day for the pain meds, so I hope that she’s ready. I wish she could tell me how she’s feeling.

She did seem happy to be in her regular bed this afternoon so despite it being big and fluffy, I moved it back into her favorite spot at the base of the bed.  Ironically, I just got this bed because I thought she should have a more comfortable, supportive bed in her senior years. I’ve watched her sleep half on and half off her cheap, but perfectly adequate CostCo bed forever.  The stuffing no longer holds together so her aging joints are often on the floor.  So I broke down and bought her the bed she deserves, and a month later, she was diagnosed with cancer – poor puppy!  One morning I woke up and found Daisy snuggled in next to me and my daughter asleep on Daisy’s bed.  She said Daisy was in it when she crawled into it in the middle of the night. This pic is pre-surgery.

Daisy shares her bed with sister Ingrid
Daisy shares her bed with sister Ingrid

Daisy Becomes A Tripawd

Surgery was last Wednesday June 5th.   The surgeon called that afternoon to let us know everything went smoothly and she was in recovery.  He said the joint was pretty trashed. We’d wait a few more days to confirm the biopsy results. The first day they said she was still really groggy and unable to walk, so they kept her another night.  Friday, she was a ‘new dog.’  She rolled on her back to let them pet her tummy, going outside to pee with the support of a sling, and generally doing much better.  When we picked her up, I was a nervous wreck.   I wondered how she’d look and how she’d react to seeing us.  I was worried about how much pain she’d be in and what the next week would bring.  Consumed by these thoughts, I went the wrong way, missed the exit and was half an hour late! Fortunately, they didn’t seem too frustrated with me.  After the tech took us through the detailed post-op care, they brought her out.  It was so great to see her.  I don’t know if she was just really happy to see us or hopped up on morphine, but we haven’t seen quite this much energy since.

The first night we had her corralled in a small space with her bed in the living room.  She didn’t want to eat, which didn’t surprise me, but all her meds need to be taken with food, so I didn’t know what to do!  I worked through it with the vet, but she ended up eating enough pizza crusts and treats that I gave her all that was needed. We gave her a sedative as well to take the edge off. We also learned the biopsy results. It was NOT synovial cell sarcoma as originally thought. It was a more rare peripheral nerve sheath tumor that had eaten away the bone and cartilage. The lymph nodes were clean which was a relief. He said this was an unusual location for this type of tumor, and we may want to follow up with an oncologist. It is more responsive to radiation than other cancers, but spreads more slowly, so I think this is good news. I have a follow up with our regular vet on Monday. If there’s no cancer in the lymph nodes or lungs, I’m not what sure we’d be treating at this point. Perhaps it’s simply to have a plan for monitoring her.

Daisy was a trooper this weekend, eating bits of bread with peanut butter and little snacks. I used vanilla yogurt to convince her to go outside to potty.  On Sunday, she definitely perked up, started eating her regular food, and even hopped out to the yard by herself before I could chase her down with the sling.  She’s still pretty much laying in her bed, but she wanted to lay in the grass for a while today. We take turns sitting near her and petting her which she likes.  I’m looking forward to the day when she’s feeling like herself and hopping around the house on her own.   She made it through the first four days, and we are breathing a huge sigh of relief.

Daisy comes home
Daisy comes home

Relaxing In the Yard

Our Old Gal’s a Good Candidate for Amputation

The following week, (last week of May) I met with the surgeon. After reviewing the x-rays, but without the bone biopsy, he thought it was very likely synovial cell sarcoma, and that Daisy was a good candidate to be an amputee. I walked into the office thinking we were just going to schedule a biopsy to confirm the diagnosis and pain remedies for whatever time she had left, and went home with a renewed sense of hope… and anxiety.  He thought with amputation, she could live on average year to eighteen months, assuming the diagnosis was confirmed, which would bring her to the ripe old age of 13, pretty good for a Golden.  Without it, probably six months in pain, although managed. She’d get to a point where she wouldn’t be able to put weight on that leg and be hopping on three.  He reiterated what I’d heard from others that dogs do really well with three legs, even older ones and thought that given that her chest scans looked good, her bloodwork was ok, and her other joints didn’t seem to have any issues, she’d do well as a tripawd (although he didn’t use this term!). He said he’d want to get an x-ray of the other shoulder before surgery just to be sure.  He also mentioned some other tests that we could do to confirm both diagnosis and that the cancer hadn’t spread, but together they were almost as much as amputation surgery.  We knew she was in pain, the bone had been eaten away significantly by the tumor, the tumor was fairly large and had been there a while, and the vet had a  90% comfort level that it was synovial cell sarcoma.

Like any dog parent, I went home and started googling and found the Tripawds community.  It was so helpful to find people who were weighing this decision as well for a variety of conditions.  I felt a whirlwind of emotions from guilt for wanting her to live longer, sadness that she was in pain and not able to live comfortably, anxiety thinking about what recovery might be like and how we could afford it, and finally hope for the full life she could live when she recovered from surgery.

I called on an old friend who’d worked with hundreds of shelter animals in rural Indiana. I asked whether she’d had experience with leg amputation, and of course she had been through it with dogs on several occasions.  She reassured me that even older dogs tend to adapt and do well as amputees. She said she wouldn’t sugar coat it. Recovery would be rough and the first two weeks are a major adjustment. But after that, she said they’re out of pain and usually do really well. Assuming she was otherwise healthy, she thought Daisy would be 100% in about three months.  Most importantly, she suggested that I not focus on the near term pain. I had to focus on the long term quality of life and life expectancy.  She said ‘of course she’ll be in pain, she just had her leg amputated! But be patient, and she will do just fine.’

After consulting with both of our veterinarians who agreed Daisy’s prognosis post amputation was relatively good and she could handle the surgery, I nervously made the call to schedule the surgery. We opted not to do the more invasive bone biopsy in advance as it would put her through yet another round of anesthesia, and more than likely the leg would need to come off anyway. I also didn’t want to lose time, knowing it was spreading. In the days prior, Daisy had trouble getting going in the morning and hobbled to her bed at night.  She had moments where she’d run across the house or jump up on visitors and I was reminded that  her spirit hadn’t given up despite her bum leg.  She really seemed normal except for her limp. She even asked to go on her walk every night, which of course we didn’t entertain. In a way, she reassured me that we were doing the right thing.

More Than Just a Limp

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“This feels like it could be a tumor.”  My heart sank the moment my veterinarian said it.  We’d been blessed with a healthy Golden Retriever for 9 of her 11 years, and our luck had finally run out.  We adopted her from a relative when she was two years old.  We didn’t have kids yet, and she was indeed our baby.  I heard my former vet’s voice in the back of my head. As he’d knelt on the ground with her and nuzzled her face like we did, he remarked what wonderful dogs Golden’s are, but it’s too bad they’re “tumor dogs.” Even though I knew this to be the truth, no one ever mentioned what to look for, nor did I ask. I didn’t know that a persistent limp could be a sign.

I held my breath at her regular appointment in April as the vet carefully checked her lumpy lipoma-filled skin, looked in her ears and eyes and everything checked out fine. I mentioned Daisy’s limp that persisted for a few days after playing fetch or after long walks, but the doctor didn’t notice her enlarged elbow unfortunately.  She’d injured that leg five years ago on a camping trip, limped for a few days and returned to normal and periodically limped on the leg after heavy activity ever since. We figured it was just arthritis.  Less than a month after her check up, I brought her in because her limp had worsened lasted for three days, and this time, I couldn’t point back to a game of fetch or a particular walk where she’d limped home.  Something wasn’t healing, so I thought we’d get a prescription for anti-inflammatories or pain meds and be on our way.

I think in these pivotal moments, the veterinarian wanted to break it to you softly, and it took me a little while to process what she said.  She recommended x-rays of the limb, and said she’d hoped they’d just find osteoarthritis in there, but she had a feeling it was a tumor.  Then depending on the type of tumor, we could talk about treatment options. I was both glad I hadn’t waited any longer to bring her in, and at the same time felt horrible for not raising the alarm bells sooner. I didn’t sleep much that night.

The next morning I brought her in for x-rays with sedation. A few anxious hours later, the vet called to tell me that she didn’t have bone cancer as they suspected, but she found an abnormality in the cartilage and she wanted a radiologist to get a second opinion.  She showed me the x-rays and I could see a round hole in her elbow joint, eaten away by the tumor – not good.  By the time I arrived, she’d spoken to the radiologist who agreed it looked like cancer of the cartilage, most likely synovial cell sarcoma. She asked to do a biopsy of the fluid so that they could try and get a firm diagnosis, but didn’t make any promises. I thought while she was already sedated we should go ahead and perhaps we wouldn’t have to put her through a separate more invasive surgical biopsy and more anesthesia. I also agreed to take chest x-rays as she said this was helpful in understanding whether the cancer had spread.  I wanted as much information as we could get so we could determine whether it was worth treatment.   As I sat outside the office with my three month old son waiting, I couldn’t keep it together any longer. The vet came outside. I could feel the tears running down my cheeks. One week prior, we’d been taking our daily walks, talking about how much puppy energy Daisy had. Now we were talking about amputation and life expectancy. It was too much! I told her that I didn’t want to put Daisy through amputation and put the thought out of my head.

Swimming in a lake - best day of 2012!
Swimming in a lake – best day of 2012!