Wednesday, February 13, 2013

A difficult decision (but not THAT one!)

As you all know, our little fur-baby PG has been fighting cancer these last three and a half months (since before Halloween). We've been doing pretty well, she's been getting special food (baked chicken and broccoli/cauliflower/carrots and cheese) morning and night, and she LOVES her new food. She's also been wearing a splint on her foot as she still has no feeling and will break her toes or foot without it.

I've been fighting the sores on her foot in 2 areas that make contact with the splint, but I FINALLY think I have them under control. Of course, PG doesn't have a care in the world as she can't feel them. I had been taking the splint off every day, cleaning and slathering the open sores with Neosporin ointment and re-wrapping her foot up before clamping it in the splint/brace. But I was getting NOWHERE with all that effort...the sores just would not go away. Recently I shifted my strategy and started using the non-stick large pads (and still slathering with Neosporin), then wrapping the pad with the medical wrap tape (looks like cheesecloth), THEN velcro'ing her foot in the brace, wrapping it over with an Ace wrap (the stretchy stuff) and finally covering the whole thing with athletic tape leaving only the tips of her toes exposed (so I can verify it's not too tight).

This method has been working great, and the sores have FINALLY healed...they are now just large pink spots with no hair. I still pull the splint every week and clean her foot good (being as she can't get to it to lick it clean) and re-do the entire affair. We have been hoping against hope that the feeling would continue creeping down her leg and eventually get to the foot/toes, where we could take the brace off FOREVER. That just doesn't appear to be likely. A few weeks ago we had her down to Ventura at the medical center where her surgery was done (back on Halloween Day), and the surgeon told us the feeling hadn't moved any further down in the last month. That wasn't the news we were hoping to hear, but it could always be worse. So she wears a brace for the rest of her life...I could deal with that. But looking at it logically, that wouldn't be fair to her. She can't totally use the leg normally...mostly because of the brace. I have it as small as possible while still protecting her 'ankle' and foot/toes. But it's still a solid clunky piece of gear strapped to her leg. She can't run with it, so she runs with 3 legs carrying the splint as she goes, only tapping it to the ground now and then. But she does use it quite well when walking/standing, and it does indeed protect her from hurting herself.

However, last weekend when I was giving her a bath I noticed that her leg had started to swell again. THAT is a game changer. We spent a LOT of money on the initial surgery and after-care. Looking back with the hindsight goggles, I wish they had just taken the leg on that day and been done with it. But we asked the surgeon to save the leg if possible, and only take it if needed to save her life. And that's exactly what she did. She had found the bleeding tumor and was able to remove it without having to remove the leg. It was only days later when the biopsy came back that we learned it was a malignant tumor, and what kind. But you can't turn back the clock and get a re-do, and at that time we were very happy she was able to save the leg. But right now we're heading right down the path we took months ago. We've had many people including the surgeon and oncologist) tell us that the prudent thing to do is take the leg. Due to this type of cancer, it almost ALWAYS comes back....and right where it was before. This is due to the little fingers that go from the tumor into the surrounding area from this explicit type of tumor. There is no way to get enough "Margin" shy of amputation. But we didn't know that on Halloween day.

So. We've had months to watch and wait, hoping against hope that the cancer won't return. We've changed her diet and she loves it. We visited an oncologist 2 weeks ago and had planned on starting her on low-dosage chemo pills in two more weeks time (we needed to do one more blood panel for the oncologist, then he would prescribe the chemo). But that was looking to be a 'rest of her life' treatment. We don't even know what the cost was going to be, he (the oncologist) said there is a place in Arizona that will make her pills exactly in the right amount for her size, and be cheaper than even Costco (which also sells this chemo drug). Then we would have had to worry about her 'poo'...as it would be toxic to the other two fur-babies.

And so...all week Jeannie has been hammering the phone lines, talking to everybody who could possibly do the amputation surgery in a reasonable amount of time (ie: we can't wait a month). She had found that the University of Davis has a veterinary school program, and they do things like this for basically cost. However they are booked up for the next 3 weeks, with only the slight possibility of a cancellation for us to slip into. ALSO, for whatever reason, they would not do the surgery if the leg was too swollen (which I can't figure out...they are removing the leg BECAUSE it's swelling up...but I"m sure they have their reasons). last night I took a series of pictures of her in various positions and angles, and emailed them 13 shots showing her leg in every angle (and also some shots of the other leg for comparison). Jeannie had also been talking to the original surgical place down in Ventura, but they are quite pricey (but the service is FIRST RATE!). We really didn't want to spend another 3 to 5 GRAND having this done, but having her put down also isn't really an option for us. There is a surgical place up in San Luis Obisbo that would charge in the 3 grand range...but the medical school said it would be under a grand (and if she's less than 40 lbs it would be around $650...her weight is right around the 40lb mark).

This morning Jeannie got PG up to a surgeon in Arroyo Grande (about 15 miles away). This is the man who has done all 3 leg surgeries on PG over the years, and one stomach surgery on Sydney. He is an EXCELLENT surgeon, of that we have no doubt. We do have some thoughts about having a medical student do the surgery, even if it is cheaper. I mean, what would you do for YOUR child?

ANYWAY. The decision is moot point it turns out (I mean the decision as to who/where to have the surgery done). Dr. Sikes (our local surgeon in Arroyo Grande) came thru after examining PG this morning with a very reasonable price, that is more of course than the medical school (which also is FIVE hours away) and thousands less than the big medical center down in Ventura. Jeannie called me today and we discussed it, and both of agree that Dr. Sikes is our guy. We know his work, he's local, and he's VERY good. AND THEN! Tonight when I got home I have an email from the Davis medical school. They received all my pictures, and told us that they don't feel comfortable having their students do this surgery due to the swelling up in the thigh area (which is where the tumor was). She was very apologetic and offering other possibilities for us, but we are fine with that. In fact, it just shows that it was meant to be for Dr. Sikes to do the job.

We (well, PG I mean) is scheduled to go in for her amputation surgery NEXT TUESDAY (the 19th), and she will come home the next day (Jeannie will drop her off, and I'll pick her up). That's less than week away, giving us a very short amount of time to make our peace with the fact that our little angel will be losing a leg. I actually think we've both mostly crossed that barrier mentally though, as we've both come to the conclusion that it's the right thing to do, AND it offers her the best chance for a normal life. We won't have to live in fear of the cancer returning. We won't have to be giving her chemo pills (making her ill to some degree...as that's what chemo does) for the rest of her life, nor will we be splinting her foot so she doesn't hurt it for the rest of her life.

Of course, we still feel bad knowing we are making this huge decision for her, like all parents do for their children who are too young to understand. PG is by no means young (she's 11) but I believe she has MANY years left...and it will be great to see her run again. She is part whippet after all, and she runs like the wind...and I bet that even with only one rear leg she will run like a champion in our little park just a few months from now.  So...we prepare for yet ANOTHER surgery in our family. We sure do help put a lot of veterinarian's kids thru college!


I leave you with one of the pictures of our little darling that I took last night. The hair has almost totally re-grown in the last three and a half months, only the hairless scar (and the foot splint) gives it away that something happened. By next Tuesday afternoon this leg will be gone, and with it the cancer. And we can FINALLY stop worrying about it! But it is still QUITE heartbreaking for us to go thru with, no matter how well we feel justified doing it.

Hugs to you and all your babies, whether they have 2, 3, or 4 legs!

5 comments:

  1. I bet she'll be good as new in no time, once that leg is gone! Amazing what they can adjust to..

    Amy

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  2. Matt, I'm so glad you added "But Not That One" to your title, as I gasped when I started reading it! You are such an amazing caregiver to your little girl! I've seen so many dogs thrive after amputations - I'm sure that she will be back to her old self in no time. I think that this decision will both put your mind at ease and also give her a higher quality of life in the long run. It certainly is difficult to make those kinds of decisions for kids and pets, though! It seems like things truly did work out for the best with the doc available to do the surgery, too. Keep us updated! I'm wishing you all the best and a very speedy recovery for PG :)
    -Janann

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  3. Ahh, Matt, it WILL be okay. Truly!

    I'll be thinking about you tomorrow.

    Rae

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  4. Well...today was the surgery. Hers was the last of the day, Jeannie finally called them around 4:30 and the surgeon said she was out of surgery but wasn't awake yet. We're relieved to hear she's out, but are both questioning if we did the right thing. Our little fur-baby is lying there in a strange place missing her leg. Probably in a lot of pain, even with the medication she's getting. Did we do the right thing? Jeannie even asked me this evening if we did the right thing. It was either this or have her put down...I just don't think she's ready for the final sleep yet...she has too much life to live...so full of energy (piss and vinegar is what it is). I just hope she forgives us. I'll pick her up after work tomorrow hopefully and bring her home. Then we'll get a better feeling for how bad this is for her. Guilt is a horrible thing. I just hope we did this for her and not for us. I'm going to bed now where I can toss and turn for hours agonizing over this. That's my punishment I'm afraid.

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  5. Matt, you DID do the right thing. You thought and thought about it, and now she WILL be enjoying life to the full again. Maybe she will run a little more slowly, but she won't mind! Dogs are much more resilient than we are, I think, and you know that what makes YOU happy will make HER happy! Focus on the positives of your decision here!

    With my best wishes, Rae

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