2 weeks ago yesterday, our seemingly healthy 9 year old dog collapsed. On Wednesday July 29th, our nanny sent us videos while we were at work and we each got home as fast as we could. After a traumatic evening involving 3 different vet offices, 2 car rides praying she wouldn’t die on the way, and everything that happened in between, we left her at the animal hospital with the hope and prayer that the surgical team would agree to operate on her without waiting for additional imaging in the morning. At midnight, we got the call she was going in. At 2 am, they called saying that she had survived the surgery, and they had removed her bleeding spleen. She was stable, and time would tell what came next.
The next day, they called and said she was doing much better. We were cautiously optimistic. That night, they called and said she was having a delayed hemolytic reaction to the blood transfusion. Her packed cell volume plummeted to 18%, and it was a matter of waiting to see if her body could build back enough red blood cells to stabilize. The next few days were a blur of visiting her, hoping we didn’t receive another call, and doing our best to enjoy my little sister’s wedding (which we really did manage to do, somehow). That Monday, after 5 days in the hospital refusing to eat unless it was fresh cooked meat while we were visiting her and only while sittig outside, we were able to bring her home. We began trying to focus on the immediate job of healing from surgery, while we were also waiting for biopsy results. Chances were 1/3 that it was benign, 2/3 that it would be cancer. If it was cancer, the chances were 2/3 that it was hemangiosarcoma, one of the deadliest, most aggressive cancers. In the meantime, she recovered, starting to eat, starting to wag her tail. We passed the first hurdle. Then the second. Then, somehow, it was 2 weeks later. I began to wonder if they were saving the results for our follow up visit on Thursday, and wondering if that meant it was benign. I didn’t mind that it took so long. It let me hold on to hope.
Tuesday night, we got the call. The vet asked how she was doing, I gushed about her recovery. She said she was thrilled to hear it. And I joked “and now you’re calling to ruin my night.” And as soon as I heard her breath, I knew. She told us what we had been hoping not to hear— it was in fact hemangiosarcoma. This sweet dog now was a time bomb, and the fuse is short. 1-3 months without treatment, and we had already wasted 2 weeks after surgery. I was numb. I chatted with the vet almost pleasantly, hung up, shrugged and told my husband over the kid’s heads as they finished up bathtime. I cried a little, but I don’t think I fully registered the situation until the next morning. The next day, the flood came. The anger, the tears, the sadness, the unfairness of it all. We had been so diligent in monitoring this dog’s health—she has gone every few months for full body imaging for the last 5 years. She’s had every weird looking thing, internal and external, aspirated. Everything in her and on her has been documented. And yet, here we are. Staring down the barrel of an expiration date.
I of course began to research. Usually I am comforted by statistics. Everything scary in my life comes down to, ‘well it probably won’t happen’. When I was first pregnant, I would google miscarriage rates. Then later on, stillbirth rates. SIDS. Brain tumors, leukemia, rare blood cancers. I check the stats, and I comfort myself by saying “it probably won’t happen, and if it does, I’ll deal with it then.” And so far, that has worked. I’ve been lucky. My luck, when it comes to Loosey, has run out.
She has hemangiosarcoma. The survival rates at 1 year are considered 0%. It is fatal, and if she manages to survive longer than a year she would be such a rare case it doesn’t make the statistics. The official stats say 1-3 months median survival without treatment, 6-9 months with SOC chemo, a potent drug called doxorubicin. I began researching, collecting both facts and anecdotes.
I found that the treatment protocol is 5 IV administrations of doxorubicin, spaced 3 weeks apart. Time is of the essence, and the sooner it starts, the better it works. Microscopic cancer cells are floating through her bloodstream, even if they haven’t metastasized into identifiable tumors yet, since it is a cancer of the blood.
Anecdotally, people who had experience with hemangiosarcoma were split into two camps. Those who fought with everything they could, and those who opted to try to focus on making whatever time was left as good as possible without doing any medical intervention (aside from herbal supplementation and accupuncture). I realized that I only heard from 1-2 people who regretted doing chemotherapy. Everyone else reported that the chemo was well tolerated, with some lethargy and tummy upset the days after being the only symptoms. People also suggested yunnan baiyao, and ‘ImYunity supplements. I got my hands on those right away, and started today.
I also made appointments with two oncologists for today and tomorrow. I called in every favor to get the one today, and the other was sheer luck that there was an opening within the week. After speaking with the first oncologist, and doing more research on every option, we’ve opted to move forward with starting chemo (pending her imaging and bloodwork says she’s a candidate. There’s always the chance something comes up that disqualifies her. I will be high-key devastated if that happens.)
How we decided on trying to do chemo was a multifaceted, carefully considered equation.
1) She is relatively young (9), and in overall good health. She doesn’t have other comorbidities, other than her previous history of cutaneous mast cell tumors, and some general wonky hips and allergies. She runs, plays, hops, jumps, and enjoys life. She loves playing with her sister, and is physically strong. She has recovered pretty much entirely from an emergency splenectomy in 2 weeks.
2) She has tolerated chemo extremely well before. She did 6 months of oral palladia 5 years ago for her mast cell tumors, and she had no side effects. Obviously this is a much stronger medication, and she is older, but we are hopeful she will tolerate it well this time too.
3) It is not all or nothing. We are obviously putting her quality of life first, but there’s a chance the chemo won’t impact her quality of life too much. We are proceeding with each infusion as a potential last: if she can’t handle it, we won’t do more. We are hopeful she will be able to do all 5 infusions, but only time will tell. She is also getting supplements either way, unless they upset her stomach too much.
4) There is a clinical trial being run for a vaccine that inhibits the cancer growth, and I want her to be alive long enough to be in it. Whether it will work for her is unable to be known. But the thought of her being able to have this chance to a) live longer without pain and b) help the future of veterinary medicine so no one else suffers like this is incredible. We don’t know yet if she will qualify, but I really hope we can participate.
5) We are also considering the health and wellbeing of our entire family. This is our younger dog, and our older dog also has cancer (transitional cell carcinoma). They are extremely bonded, and when one is without the other she paces, whines, and can’t settle. Penny has already approached her 1 year prognosis. We did not do chemo for her, but we did do several sessions of targeted radiation to inhibit the tumor growth. So there is no way of knowing how long she has. In all likelihood, we are looking at going from 2 to 0 dogs in the next year. But if we can have them together for as long as possible, we will be happy. Maybe they will even decline together, and never have to live a day without each other. We are hopeful it is not that time yet.
6) Cost is not a concern. We have been paying monthly (expensive) pet insurance since she was adopted at 8 months old. We are generally reimbursed 90% on treatments and necessary imaging. We are privileged enough to be able to afford both the insurance and the 10% cost on whatever her bills are. We do not take this lightly, but we are very lucky to not have to consider the likely exorbitant cost of doing this.
So, here we are, the night before chemo (hopefully). Again. Tomorrow I will drive her 1.5 hours in rush hour traffic to and from Manhattan to get her treatment, and I will hope she feels ok after. I will cross all my fingers and toes for more time, and not just more time but more good time, with our sweet Egg.
