Pugsley: aka, the Sausage.
Lori: Loves Pugs. Writing. Food and Fashion.
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I am waiting on my fourth opinion about what to do with Pugsley….
He has an enlarged malignant lymph node that has actually regrown in the same spot where it was surgically removed 6 months ago. Remember this was back in December when they told me he would most likely not live to see the summer. Before that the first oncologist in summer 2006 said he wouldn't live to see summer 2007.
Well, to give you an update his quality of life heading into summer 2008, it has been and still is off the charts these days. Seriously, when I say it's better than mine I am not exaggerating. He has a great zest for life. He loves his food and toys and lives for treats. He goes on weekend adventures with me and everyone who sees him says how great he looks and acts. He is still a very happy, spunky boy. He dashes around the house like a lightening bolt@! And by the looks of him and knowing what a fighter and lover of life he is, seems far from giving into this wicked disease.
BUT all things considered and him being the superpug that he is, the reality is he does have this mast cell cancer raging through his body. Every 6 months it seems to crop up. In addition to the enlarged lymph node on his chest he has 2 other skin tumors that I noticed last week, one on his inner hind leg and one on his back. And as I was at the vet this afternoon checking him all over I noticed quite a few more. All over. They are spreading on his head, side, stomach, back inner thigh……..oh help me to know what to do.
These don't concern me as much as the big lymph node one though that changes size day to day ranging from a golf ball to tennis ball in size. The fact that they are all cropping up at once again is alarming. He has also been licking a lot which makes me think the mast cell histamine is causing an allergic reaction and could be seeping into his blood stream. Tonight I came out and asked the doctor to tell me if this is the beginning of the end. He responded with a very somber but firm, "Yes."
The big unknown is when will the end come and will my choices help it be a better ending one way or the other?
I am very torn about what to do. I know I said no more surgeries as a treatment for cancer but now it's about keeping him comfortable and extending his quality of life for as long as possible. I don't think that is being selfish or just trying to keep him here for me either. If he was not having fun at all or gave the slightest indication that he's getting tired, there would be no question. Instead he is just the opposite. He's enjoying life now more than ever! So I think I owe it to him if it means he can have both quality and quantity for a little while longer.
Just a little while longer. It's not his time.
If I do nothing, this mass is going to continue to grow at a very rapid rate until one day he opens it or it eventually explodes on its own, releasing toxic amounts of histamine and heparin in his little body sending him into anaphylactic shock.
I don't want that for him…
My other option is to have it surgically removed like we did the last time maybe giving him another 6 months of this life that he loves so much…if we are lucky.
Given that he is acting so incredibly zippy and spry my gut tells me he can handle the surgery and it won't affect his quality of life for more than one day as he is recovering. And 6 months on a dog's watch is like 6 years to us.
I don't know what to do but I am leaning towards having at least the big one removed. At least this was my thinking before doing a full body scan and finding 7 tumors from head to tail. Would I remove those too while he is under? I don't want him all cut up like a Frankenstein. Even though he wouldn't notice or care. Dogs have no sense of vanity or ego, it would be me feeling guilty at the looks of him. That shouldn't factor into my decision though..
One of the doctors recommended surgery; But that was without knowing recent facts about the multiple tumors. The other Dr. has a call into the 3rd Dr., Pathologist / Oncologist who performed the last round of biopsies to see what makes the most sense for Pugsley at this stage (Stage IV) and what will give him the greatest chance for quality and quantity, or should we just focus on one and not the other at this point.
I am waiting on the 4th doctor to call me back, The naturalist to give me his weigh in. Other than the enlarged lymph node and multiple skin tumors he has no signs of systemic involvement at this point. His appetite is gigantic, his stools look normal; there is no vomiting, no lethargy, no signs of stomach pain or ulceration. He does have some weight loss and they explained that is because those fucking cancer cells are gobbling up his nutrients which now makes sense why he is so incredibly hungry all the time despite eating 4 times a day with plenty of treats of in between.. I thought it was the prednisone and maybe it is partially but its the damn cancer stealing his food supply so it can keep growing and spreading like the parasite that it is. He did have a slightly elevated temperature tonight and the big tumor is hot to the touch...
No matter what I do the cancer will eventually win. It will travel to his liver, spleen, or heart or enter his bloodstream in toxic masses. But which way is worse? Which way is better? I just want to do whats best for him and I'm frustrated because I don't know the answer to those questions. I was hoping the Dr.'s could give me the answer but the ones I've spoken with so far don't even seem sure in this case.
They haven't encountered a dog who has survived 22 months with a Grade II / III on surgical removals and herbs alone. Also, they don't know Pugsley like I do. He is a total fighter and he will stick it out as long as I let him.
What would you do?
2wildpugs commented May 28, 2008 09:01 PM
Lori,
I am really really sorry that you are faced with this choice again. I am a big believer in the quality of life argument. If it were me (and I am truly glad it is not) I would work with my doctors to predict the ratio of quality of life vs. extension of life he could expect from the surgeries. Once the ratio was less than 50%, I think I would be inclined to let things run their course. For example, if surgeries would extend his life for 6 months but he would be in pain and / or immobilized for 4 of those months.... But, as long as the ratio was favorable, I would keep fighting - and that is NOT being selfish.
I wish I had better advice. I am sorry. I'll make another donation to your rescue group in your name.
Kim commented May 28, 2008 11:18 PM
Lori,
Wow,,I feel your concern. It just takes over our lives. My bullmastiff had cancer and she had chemo and it helped her for quite a while , She seemed happy and comfortable.
After about a year the "dreaded " cancer came back and she gave me "the look". I swear she locked eyes with me and wouldn't break her gaze. It was really like she was telling me she was ready. She passed shortly after. It's kind of hard to explain but I think when Pugsley is "tired" he'll let you know. Man...it's so flippin hard. Especially when he seems to be feeling fine.
Best to you and Pugsley during these difficult times,
Kim
sandy commented May 29, 2008 01:09 AM
You have been so good Pugsley and he's so good to you! I know whatever decision you make will be what you need to do. He is such a survivor! Just hold him tight and kiss like you always do through this. We lost our Baxter to bone cancer last year. After his leg broke and they pinned it together and took a biopsy and we we were told all the options and the expectations of living his life and having to have ampuation of his leg...it was our decision to let him live out the remaining time without more surgery and chemo. It was so hard to let him go, but when the time came, he was hurting and I had to let him go. It still makes me cry to think of that decision. But having him in my life for the time that I did was wonderful. I'm sending hugs your way and praying for peace for whatever decision you make.
marni commented May 29, 2008 07:56 AM
I would take the lead from Pugsley and follow your heart. He will let you know what is right/wrong. If the docs recommend surgery and feel like it is best, then go for it. Especially now while the Sausage is in a good place.
You'll know what to do...
Tammy (Norman's Woman) commented May 29, 2008 10:26 AM
I'm so sorry you are going through this Lori. I think of you and Pugsley often and pray for you both. I would have the surgery to have the big tumor removed if it were me. Pugsley has proven he is a fighter, and if his quality of life is good right now, I would fight to keep it that way. I would wait for his quality of life to decline before considering the unthinkable.
SL commented May 29, 2008 12:17 PM
SL,
I have to agree with many of the comments above... you and Romeo are so connected that he will let you know when he's grown too tired. I firmly believe he will help you to make the correct decision(s) that work best for both you and him.
Meantime, give him as many bullysticks as he can handle! I'm so glad that the two of you are having more playful and together moments.
Love to you both always,
Pugsleys Auntie YFSL
lex commented May 29, 2008 01:21 PM
Hello,
I have been reading your blog for alittle bit now (since it was mentioned on Meimei and Miko's blog) and I feel like I should throw my two cents in.
I am soooo sorry that Pugsley's cancer is spreading, my heart just aches for you two.
Looking at the surgery is important, the one lymph node one that is constantly changing should probably be removed if he worries at it, personally I would say remove the ones that will be the issue, the ones that require the least invasive efforts to remove, the ones that Pugsley can lick and scratch at. That way the effects of the surgery (should hopefully be less) and he won't be all cut up either.
It's hard to choose but since his quality of life is doing well, you can prolong with minor surgeries/treatment.
Can I ask you if they offered chemo or radiation? Would they help?
Pugs are special gifts and I am so glad that you are enjoying your time with Puglsey and he is obviously enjoying his life.
greg commented May 29, 2008 07:56 PM
Lori,
Man this is tough. I agree with the above. The Sausage will let you know when he is ready. As long as he is enjoying himself and not hurting you should go ahead with the surgery. When my buddy Jake was battling cancer he also gave me "The Look" We know it was time. He was such a proud German Shepard it broke my heart to see him start to lose his pride. It was the best thing I could do for him. I loved him so and still do. I am tearing up right now and it has been 6 years. He will always have a place in my heart and Pugsley will always have a place in yours. My new buddy Brutus the Shepard Boy is a wonderful dog and I love him so much that it scares me. But you have to know going in that you will outlive them. It is worth the pain to have some one in your life who loves you so unconditionally. You are a dog lover and I think you know what I mean. Many people do not. I feel sorry for them. I will be thinking of you and Pugsley. I know you will do the right thing.
Greg
Nevis commented May 30, 2008 11:55 AM
I have no idea, Sweetie. (((hugz))) Pray for guidence. Go with your heart.
Kelly commented May 31, 2008 09:41 AM
I am sending lots of prayers out to you and the Sausage!
Michelle commented June 2, 2008 04:46 PM
My heart goes out to you and Sausage. I dont have any advise except to tell you that I am also dealing with the same situation as you so it is comforting to read all that you have posted here on your blog.
My Miss Penny is an 8 yr. old Boxer, just last year she started to develop MCTs. Miss Penny had her 1st sugergy April of 2007 to remove 4 of them (3 on her neck 1 on rear hind leg); December 2007 removed 1 BIG hiney-cheek tumor and 1 tumor on her side, then Feb 2008 we removed 1 more neck tumor (same spot) and 1 big one on her right breast. What SUCKS is WITHIN 10 DAYS she started to develop 2 more tumors on the inside of her hind legs!!
I went out of my frigen mind and still am going crazy. I just cant keep putting her through all these surgeries, cut her open and then BAM have a bunch more develop over-night.
My husband and I agreed to not put her through anymore surgeries, it seems like the more we cut her open the faster they start to develop all over. Everyday I seem to find "1 more" especially little ones like the size of a pencil erasers and it DRIVES ME INSANE!!
I also believe in Quality Vs. Quantity, as I had lost my GSD 2 years ago from cancer and I took way too long to let him go so I promised myself I would not do that ever again to any one of my family members.
So instead of doing more surgeries, or do nothing.....I took Miss Penny to see a Holistic Doctor. The 1st Apt. was April 29, 2008, they did some acupuncture and got lots of chinese herbs to clean her blood out, and changed her diet to LOTS of green veggies, salmon & boiled eggs. The first couple of weeks has been good, she ate everything no problems except for 2 more tumors I now notice. We went back 1 month later just last week May 28,2008 for more acupunture & herbs, but since we have more tumors developing they increased the amounts of pills to give and added 1 more herb to her diet & removed 1 herb too.
My issue right now is for the past 2 weeks Miss Penny is having a hard time eating her greens - she LOVES the fish and the egg whites she spits them out....then she also di-sects her food and spits out all the medicine that I put in her food bowl. And if I put the pills down her throat she spits them up, the other day it was like 5x trying and everytime she spit them out, so to me it seems like she is trying to tell me the hell with all of those pills mama - it aint going to work - just let me live out my dying days & let me go back to eating whatever I want - she also started to drink ALOT more water than normal and the holistic vet said most likely it is the herbs. I was instructed to feed her more wet food and less or no dry food, which I've now started since last week but Miss Penny is still picking through her food and only eating the fish. And if I sprinkle her food with the medicine in the capsules, she wont eat her food at all. I am literally going OUT OF MY FRIGEN MIND to know what to do also. I just dont know!!! and I wont let her starve to death so I give in and give the normal food she wants.
and my husband thinks the Holistic Doctor is making it worse, says the chinese meds are making the tumors worse. Really makes me feel good ha?
so we both agreed that I make an apt. with my regular vet, we go this friday, so that she can understand what the holistic vet has been doing for the past 2 months and to check Miss Penny out, maybe take some blood samples & stool samples, look at these other tumors that developed and see what she thinks should be done for her. Miss Penny has a good appetite, she's an inside dog so she doesnt run around alot and we live in Florida & with the summer heat she's not active at all, but seems to still be in good spirits, but I still dont know what the hell to do about this just like you. My heart goes out to you and Sausage, If there is anything I can do please let me know, I am here for you. I will continue to pray for you and Sausage also. I am hoping maybe you can share with me the diet that you are giving to Sausage, maybe it will help Miss Penny and her eating habits. God Bless all of you.