Learning to Live with Canine Lymphoma

Saturday mornings are usually a comical routine around our house.  I want to sleep in, and Meg-Meg, my four-and-a-half year old Cockapoo, wants to get up and play.  In fact, I can usually bet that sometime between 5:45 a.m. and 6:15 a.m. I will be greeted with a sloppy wet pink tongue across my face.  When my eyes finally open, looking into them are the big brown sweet eyes that I have grown to love so much since little Meg bounced out of an animal rescue’s vehicle two years ago and into my arms.  Who could say no to that cute face?

But on Saturday, July 21st, 2012, I awoke a little after 7:00 a.m.  Meg was still sleeping, and when I asked her if she was ready for her treat and to go outside, she didn’t really move.  I figured it was because Brandon, my husband, had been gone for the last few days on business.  Reluctantly she followed me out of bed and into the kitchen, where we started our normal routine.  About 9:30 that morning I noticed a hot spot on the side of her right ear.  As I bent down to check it, I noticed something even more alarming, a large lump in her throat.  It appeared she had swallowed a golf ball.  While hot spots have been a normal thing with Meg, she has never had a big allergic reaction to them.  So I became alarmed and we called a vet in town who only does appointments on Saturdays.  She agreed to try and work Meg into her schedule.

We arrived at Wisdom Animal Clinic in Texarkana at 10:30 a.m. and waited until 11:45 before she was finally able to be seen.  A very friendly Dr. Rachel Parris came in to do Meg’s exam.  She calmly explained to me she wanted to take a sample of Meg’s lymph nodes, just to see what she was dealing with.  She told me not to be alarmed at this point, but after looking at the sample, she was worried Meg might have canine lymphoma.  My heart sank.  She wanted to send the sample off to a lab to double check her.  We would treat it as an infection with antibiotics and a steroid to help with the itching until the lab results come back.

Sunday to Wednesday saw a return in Meg.  The golf ball in her throat had gone away and her hot spot was healing well.  I was excited – the vet had been wrong in her assumption.  Meg was doing fine and it was just an infection.  The antibiotics worked.

On Thursday morning I got a phone call from Dr. Parris.  The results from the lab were back.  She was sorry to inform me that Meg did have lymphoma.  She began explaining to me over the phone what all that meant.  Without treatment, Meg would have 4-6 weeks to live.  We could keep her on the Prednisone steroid throughout the treatment but at some point her body would build up a resistance to it.  She recommended I take Meg to an oncologist in Dallas to get Meg’s cancer staged and start chemotherapy, but even then, with chemo, Meg’s chances of survival would be between 6 months and 2 years.  The cost for treatment she estimated to be around $5000-$6000.

As Dr. Parris continued to patiently explain things over the phone, it hit me.  My best friend in the whole world had just been diagnosed with cancer – and there was no cure.  I began to cry, though I tried to keep the tears back until I hung up the phone.  As I sat in my office at work the tears just kept falling.  How could my sweet, white ball of fluff, be diagnosed with canine lymphoma.  How could my dog who appeared so healthy when I left for work this morning actually be dying.

I picked up the phone to call my husband and share the news with him.  If we were going to go the treatment route, we needed to make that decision today.  Lymphoma is a very aggressive cancer and it grows quickly.  The sooner you can treat it, the better chance your dog has of staying in remission longer.  I wanted to run home and be with Meg and Brandon.  But I had to work, at least until the Teleseminar I had scheduled to host on “Customer Service’ was over in about four hours.  I clocked out and began researching canine lymphoma.  The more I read, the more my heart sank.  There truly wasn’t anything I could do to save her.  There was some optimistic news, a few dogs had lived to four years with treatment.  And I read that most dogs aren’t affected by chemo the same way humans are.

Just as my teleseminar was ending, I heard the jingle jingle of Meg’s collar in the hallway at the office.  Brandon had brought her to work to see me.  She came bouncing in full of energy and kisses.  How lucky she is to not know what we know.  To her, it’s just another day.  If she feels bad at all, she doesn’t show it.

I left work and we headed to see Dr. Parris at Wisdom Animal Clinic.  We had been able to get Meg an appointment on Friday with Dr. Erin Roof in Dallas.  Dr. Parris gave us Meg’s vet records and answered the few questions we had.  We were so thankful to her for all she had done for Meg.  I suppose as a vet, it’s got to be hard to tell someone their dog has a disease you can’t heal.

Meg, Brandon, and I then headed to PetsMart.  I don’t know why we did it, except it just felt like we needed to spoil her a bit.  Meg loves PetsMart.  We let her pick out a new bone to chew on.  She really wasn’t interested in getting a new toy.  From there, we took her thru the drive-thru at ChickFilA and got her some chicken bites.  (We later learned that the breading on the chicken bites aren’t good for her — as carbs feed lymphoma cancer cells.  Meg is now on a no-carb diet).

Friday morning we woke up to storms.  In order to make Meg’s 10:30 a.m. appointment in Dallas at the Animal Cancer Hospital, we left the house at 6:30 a.m.  We arrived about an hour early, and we took Meg to her first dog park.  🙂

When we got to the vet, the receptionist was really friendly.  She told us to help ourselves to tea, soft drinks, or water.  I made Meg a cup of water, and we attempted to play with her plush toy we’d brought.  She really wasn’t in the mood to play.

Soon we were joined in the waiting room by a man and woman and their daschund, who had been diagnosed with lung cancer.  This was the daschund’s second treatment for cancer.  They told us she handled the chemo fine the first time and always had energy.  They’d spent almost $6500 on her first treatment.  She’d been cancer free over a year, but now she had lung cancer.  They’d been treating her since May, when her bi-yearly screening showed the new tumor.

About 10:30 we were taken into Meg’s vet room — the last room on the left at the Animal Cancer Center.  Meg and I played together on the floor.  We were in the middle of a game of porcupine when Dr. Roff walked into the room.  She sat down on the floor with us and for the next 40 minutes we discussed the reality of Meg’s diagnosis.  We discussed treatment options.  We discussed how we’d know when it was time to say goodbye.  Dr. Roof was so compassionate and caring.  Oncology is all she does.  She told us no choice we made would be the wrong choice.

She also told us about something new in canine lymphoma – bone marrow transplants.  For about $15,000 in North Carolina or California this treatment option is available.  It is the only known possibility of a cure for lymphoma.  Unfortunately, it’s still in what most would consider the research phase.  Only 23 dogs have had it done.  One has died from the treatment.  The rest seem to be doing well.  As promising as the surgery sounded, Brandon and I both know we don’t have $15,000 +travel expenses to spend.  Plus, the surgery isn’t a guarantee.

For us, the hardest decision was to start chemo or not.  As a brand new married couple with our first mortgage and not much in savings, deciding to dedicate $6000+ to Meg’s treatment, plus trying to find time to get her to Dallas every 4 weeks for chemo, plus to a vet in Texarkana every Friday for chemo, was a daunting reality we now faced.  Meg is like out daughter.  In fact, I call her my dogter!  🙂  She has been a part of Brandon’s and my life since 2 weeks after we started dating.  She’s gone on vacations with us.  She goes shopping with us.  She eats dinner with us.  She is the thrid part of our family.  Many people don’t understand that — but many people do.

I bought an e-book on-line called Help Your Dog Fight Cancer.  In it there was a line that made me feel better…
“What is a dog’s life worth? The typical pet dog will not grow up, develop a career and contribute to society. He will not support you in your senior years or take care of you when you become feeble. He won’t even bring you a cup of tea when you’ve got the flu!

Dogs will give unconditional love, loyalty and companionship. Indeed, a dog will devote his entire existence to the solitary purpose of pleasing the special person or persons in his life. This is the gift of the dog. In return, we must at the very least give our dogs love, excellent care and respect.

As we sat in the vets office for almost an hour after Dr. Roff stepped out, Brandon and I debated what to do.  Facing the cold hard facts, Brandon and I had just taken in about $5500 in monetary gifts from family and friends for our wedding in June.  We were going to put that money towards remodeling our sun-room into a spare bedroom so we could start our family.  Now we had that money to spend on Meg’s treatment.  But was it the right thing for her?  Was the investment worth it just to prolong the inevitable?  Should we spend the $5500 so Meg could live between 6 months to a year, instead of between 4 weeks to 6 weeks?  And if we did, would that be a quality life for Meg?

Dr. Roff had assured us, as had most of the things we had read on-line Thursday, that chemo didn’t affect dogs like humans.  And that if it was going to affect Meg, it would affect her within the first 3 days.

In the end, we decided to start the chemo treatment.  We opted not to do all of the tests for the staging.  Instead, we just did blood work.  Her first chemo treatment cost about $650.  The office visit with Dr. Roff was $135.  The bloodwork and the lab test to determine if Meg’s lymphoma was B-cells or T-Cells cost and addiontla $465.  We could have had an ultrasound, an X-Ray, and a biopsy done, but that would have easily added another $1000 to the initial investment in Meg’s care.  Dr. Roff reassured us that no matter what those additional tests showed, she would still treat Meg’s lymphoma the same way.

We also learned that since Meg had already been put on 5 mg of Prednisone a day to treat the itching with her hot spot, the results from her lab tests might not be able to truly stage her.  She had been taking it since Saturday night (5 days before her visit with the oncologist), and the reason the golf ball had disappeared from her throat was the lymphoma cells had responded to the treatment.  Dr. Roff told us that was a positive for her from a treatment standpoint.  It just wasn’t a positive from the labwork standpoint.  (Important thing to note if you have a dog with suspcison of lympoma — don’t start the Prednisone treatment until after labwork to stage it has been done.  We didn’t know this at the time.  And we don’t blame our vet in Texarkana for this at all.  She was treating the hot spot on Meg’s ear, not the lymphoma).

We elected to do the Madison Wisconsin Treatment for Meg.  Dr. Roff told us that even if we started with the chemo today and decided next week or in three weeks that we didn’t want to continue it, or that for financial reasons we couldn’t continue it, it would be okay.  But that if we didn’t start today, and two weeks from now we decided to start chemo, the chance of remission for Meg would be much less.

It’s now Sunday (1.5 days after the first chemo treatment), and so far Meg is doing well.  Because of the treatment she does drink and pee a lot more than normal.  From the research I’ve learned it’s because of the Prednisone, which she now takes 15mg of per day in addition to her weekly chemo treatments.  She is also on 100% filtered water, something recommended in several of the books we read.

We are also now cooking all of her food and she is no longer on the daily dog snacks she was on because of their high-carb count.  Now she eats a chicken and vegetable mix that Brandon made her, takes a daily supplement each morning, and for snacks, she enjoys frozen fish treats.  We may know she has cancer, but she probably thinks she’s hit the food jackpot.  No more dry dog food!  🙂

From the book I mentioned earlier, I also read this:
“First, love your pet no differently than you normally would. They don’t know they have cancer and they therefore do not suffer the psychological implications of the diagnosis as we do.”
I remind myself of that a lot!  Meg’s lucky in that regard.  So I try to stay positive around her at all times.

For us, the hardest part at dinner time is we can’t sneak her a nibble of the food we snack on.  Our little “Beg-Beg” (the nickname she’s earned for her uncanny way of making everyone eating around her give her a little bite of their food) can no longer be spoiled rotten from the table.  That’s hard.  But we make up for it with the treats.

After I get off work today, I am going to stock up on some other frozen treat suggestions we’ve read about from other dog owners who have gone thru the same journey we are starting.

The biggest change in our days now is how much time we spend loving on Meg.  I’m not saying we took her for granted before because without a doubt, she’s always been showered with love.  But now we make sure to sit down and play with her several times a day.

For me, I have the deep fear inside that each time I pet her may be my last time to pet her.  I want her to know that I love her so much, and I don’t want her to doubt that for a second.  So each moment she’s not right beside me, I freak a little.  I’ve read that in time that will stop.  I feel like an over-protective mother.  Every step she takes, I want to be right there.  I want to make sure she drinks enough.  I want to make sure she has treats.  I want to love her.

If love was enough to get her through this, she’d be cured.  But I have to remind myself all the time that there is no cure.  So instead, I know I am now living with Meg-Meg on “borrowed time”.  Each second we get to spend with her from now on will be treasured – until her journey with us in the life comes to an end.  It is my goal to make sure the rest of that journey for her is filled with as much joy as possible.

We are still debating if we will continue with the chemo.  For us it’s not really about the money.  We can figure that out.  It’s really about Meg’s quality of life.  Is it really best to make her go thru chemo treatments every Friday?  How will she handle them?  So far there’s been no nausea and dihareea.  This coming Friday that could change as a different chemo is introduced.  She will go thru a different form of chemo every week before she returns to Dallas.  We’ve read about Bullet, and how his chemo caused his nails to split and bleed.  He lived four 4 years on his treatment though, and from everything we read, was happy and healthy through most of it.

There is no crystal ball.  Only time to love and cherish our precious Meg!!

It’s hard to believe it’s been 3 days already since we got the diagnosis.  It’s amazing how quickly your world and plans can change in an instant.  I always knew I would outlive Meg.  I just figured she’d be with us for six to ten more years, not six to 12 more months.  It’s tough to swallow.  On the positive side, I now know that every single kiss from Meg is special, even the ones at 5:45 a.m. because it’s time to go potty.  Sleeping in is so over-rated!  🙂