Sasha’s Diagnosis – We get bad news

Tuesday, March 6th was a very sad day at the Ruano house.  Liliana answered her phone, and it was Dr. N. on the other end.  He was calling to give us his findings about why Sasha had developed an increasingly worsening limp due to pain in her front right arm.  In the back of our minds, Liliana and I may have had suspicions of ominous news, but on the surface we had expectations, and even hope of learning that Sasha had a broken or fractured bone.  Yes, I do understand how strange and morbid it sounds that I was hoping for broken bones in my beloved pet.  The news was much worse, however.  I knew that our dear Sasha was in real trouble when I turned around and saw Liliana in tears while holding the phone.  Before that moment, I did not know that Dr. N. had called, but the sadness and pain in my wife’s face made it instantly clear to me what was going on.  Liliana could not bear to listen any longer and handed the phone to me while the Doctor was in the middle of delivering the bad news.

Dr. N. explained that he and Dr. Clary, an orthopedic specialist brought in to examine Sasha that day, had found a tumor on the upper part of Sasha’s right humerus (upper arm bone).  There was no way to say for certain without a bone biopsy, but the doctors suspected that the tumor was caused be a type of cancer called osteosarcoma.  Osteosarcoma is a very aggressive bone cancer, and it is the most common type of bone cancer seen in dogs.  The good news is that osteosarcoma almost never spreads from bone to bone.  The bad news is that it does metastasize into other parts of the body – usually the lungs.  The prognosis for dogs diagnosed with osteosarcoma is rather grim.

Dr. N. layed out our options for Sasha.  He first explained that if we did nothing, Sasha would probably live another three to four months, and be in a lot of pain for the rest of her days.  The second option was euthanasia.  The third option was to amputate Sasha’s arm, and the final option was amputation and chemotherapy.  My eyes began to swell with tears and my throat tightened.  I knew that if the doctor stopped speaking, I would not be able to respond to his diagnosis.  Dr. N. spared me for another moment as he explained his opinion of the situation, and what he would do.  His recommendation was to spare Sasha the trauma of a biopsy, and amputate the leg.  Once the leg was removed, he reasoned, a pathologist could make the determination of exactly what the cause of the tumor on Sasha’s arm was.  Regardless of the cause, he said, the arm would almost certainly need to be amputated anyway.  I continued to listen to Dr. N., in a state of half disbelief, and then in a broken voice and a couple octaves higher than usual, I thanked him and told him that I would see him soon.

While Liliana and I waited for the time to pick up our girl from the vet’s office, I began devouring as much information as I could possibly find on the internet about canine osteosarcoma.  As usual, I began my search with a simple google search of the topic.  I find that, while much of the information I find using this method is anecdotal, it gets me going in the right direction.  Other people have gone through the same situation that I am facing right now with Sasha.  I can read about the choices that they made, and possibly learn some valuable information at the same time.  The next step in my research process is to pull up as many academic research papers on the topic as I can find.  What I learned during my search for information about osteosarcoma in dogs, is that Sasha is in a very precarious situation.  In talking to Liliana about our options, we both agreed that we needed to take action.  Doing nothing was not an option, and it was very important to us that we make a morally ethical decision, which, of course, was very difficult to do in a situation like the one we were in.  Dogs cannot speak for themselves, so it is up to their human guardians to make decisions for them.  Euthanasia was almost unfathomable, but would it be fair to Sasha, a dog of almost twelve years of age, to amputate her leg, and expect her to relearn how to walk on three legs?  Would it be fair to put Sasha through the trauma of surgery, and the difficulties of recovering from such a major operation?

I continued my research and found that dogs that undergo amputations usually recover fairly quickly (begin acting somewhat normally in about a month’s time).  Animals do not share the same feelings of shame or feel the stigma attached to being an amputee.  They do not sit and think about how they are different than all of their buddies at the dog park.  Dogs get right back in the game, so to speak.  Their new condition is simply their new reality, and they continue on without a second thought.  Sasha may never be quite as agile as she once was, but if she can still enjoy things like chewing on sticks in the back yard, chasing down frisbees (albeit more slowly than before), and swimming in the ocean, then her life is worth sparing.  As long as Sasha is happy and her quality of life is good, we will do whatever we can within our power to ensure that we can continue to make good memories with our girl.