Sasha has continued to improve. She gets around just fine now, and is even able to jump up onto, and down from the sofa. The pain around the surgery site is minimal. She often chooses to lay on her right side now, and Liliana and I are able to pet her near, and even on the healing incision. We are getting ready take Sasha in to get her staples removed. I’ll make a 2nd part to this post in a few hours to let you all know how she does at the vet’s.
It’s been a while since I wrote a post. As you know, our girl Sasha was not doing well. All I could think off was how the news of Sasha having cancer changes many things. Not only have I been distraught about the news, but I’ve been trying to focus on our next steps, looking back at good memories and planning to creating as many more as we can, knowing our time with our baby is limited, breaks my heart and slows me down. However, I’m doing my best to change this attitude as I know its detrimental, and staying positive through it all is the best possible thing I could do. Sasha has recovered well from the surgery. I will soon share more with you.
This post is about how quickly plans can change. Just a couple of months ago I was thinking I would have a job by now, so I was making plans about some things that we need to take care of. As you may recall from the lists post, we have a lot of things to do. But out of everything on and off that list, there are four things Carlos and I wanted to do as soon as either or both of us found a job.
The four plans were:
Though most of our plans are on hold, for the time being, there are a few small home projects we’ll be tackling. I’ll be sure to update you all on these as we get them done.
XO,
~ L.
I’m sorry for not having posted in a while, as you all know, it has been been a rough couple of weeks. Since I have shared Sasha’s health situation, I thought I’d share a video with you.
Sasha, the day of her surgery, on our way to Dr.N’s office:
I’ll post an update on Sasha soon.
XO,
~ L.
Sasha continues to do well. We brought her back from the vet’s office on Thursday after having her right arm amputated due to a tumor on her humerus caused by osteosarcoma. Her pain seems to have diminished greatly even though we have begun to ween her off of her pain meds. She wags her tail more often, and she seems to be more comfortable when the other dogs approach her. Now we are waiting to hear back about the results of the bone biopsy. Once we get those results, Liliana and I will determine, along with our vet and the oncologist, what course of action will be taken to help Sasha beat the cancer. I have been researching chemotherapy for canines so that I will be prepared with a good knowledge base when I speak with Dr. N.. My understanding so far is that chemotherapy is not nearly as traumatizing for dogs as it is for people. I am glad about that, but I am fearful that Liliana and I may not be able to afford the cost of treatment. I’ll keep you posted.
Sasha is doing so much better. She is no longer whimpering, and she is getting around well. She can even get up and down the three steps of our deck when she needs to go outside to do her business. She hasn’t needed help to lay down for two days, and she is beginning to perk up at the mention of certain key words: park, walk, go and kitty cat. Spirits our up in the Ruano house!
Sunday, March 18, 2012: Sasha wags her tail for the first time since she came home from the amputation.
Sasha’s first night home after amputation of her right arm was very difficult on all of us. She was in a lot of pain, and dysphoric. Her eyes were wide open the entire night, and she was doing something that she never did – whimper. Sasha has been through some serious stuff in her life, including having a fishing lure with two treble hooks hanging from her lips when she was a puppy, and she never whimpered for a second.
Liliana and I stayed with Sasha through the night in our living room. We were both scared to leave her alone on a dog bed while we slept on our bed. She was not used to having only three legs, and I feared that she may fall onto her right side if she tried to stand up. Besides, I couldn’t bear to leave her alone whimpering in pain, and confused about the whole situation. I love my girl, and I’m not ashamed of being a doting dad.
I layed with Sasha’s head in my arms for most of the night. She whimpered the entire time, but she seemed to go through episodes of increased discomfort about every hour or so. Liliana and I thought that she might have to go outside, and that her need to relieve herself might have caused her increased discomfort. Every time that the whimpering increased, we took her out. Sasha always seemed to feel a little better after coming back in from the back yard. Overall though, she seemed to be in excruciating pain, and Liliana and I felt helpless. Besides holding Sasha’s head, which did seem to comfort her a little, there didn’t seem to be any way of alleviating her pain. It got so bad that we called the local twenty-four hour emergency clinic twice to see if we could start Sasha on her pain meds ahead of schedule. The answer was yes.
When the additional pain medication did not have the affect that we had hoped for, Liliana called the clinic again. She explained to the Nurse that Sasha had not shown any improvement despite being given the pain medication. The nurse offered the suggestion that Sasha may be suffering from dysphoria, and that we should not give her any more medication until her originally scheduled dose time. It was one of the hardest things that I have had to do – watch and listen to Sasha suffer so much. If I am to be completely honset, there laying with Sasha, holding her head and speaking in a soothing voice, I questioned whether Liliana and I had made the right decision. Did we make a mistake in amputating her arm? Sasha is a healthy and spunky eleven year old American bulldog, who still loves to go for walks, hikes, catch Frisbees and go swimming. In future posts I will look at the moral and ethical issues surrounding euthanasia vs preservation of life by medical or surgical means.
Today, Thursday, March 15, is the day that we go to pick up our Sasha from the Vet after amputation of her right arm due to osteosarcoma. Liliana and I are feeling many emotions as we get closer to the vet’s office. How will Sasha react when she sees us? How will we feel when first we see our girl with no right arm? The questions pile, one on top of the other, and tears begin to fill Liliana’s eyes. I hope Sasha is happy to see us.
After we review all of the care instructions, receive Sasha’s medications, and pay the bill, we are ready to take Sasha home. Liliana and I follow Dr. Patterson (he fills in for Dr. N. on Thursdays), Shelly and a tech back to where Sasha is being kept. The kennel door is opened, and Sasha looks around nervously. She is probably scared about what might be in store for her next, but our eyes meet. Now she knows that she is going home. As Dr. Patterson and the tech get Sasha out of the kennel, she let out a screech. Her scream makes it abundantly clear that she is in considerable pain, and that we need to be very cautious with her. Like the Stoic American bulldog that Sasha has always been, she ignores her pain and the fact that she is missing a limb, and makes a beeline directly for me. To be completely honest, Sasha was more likely heading for the door to get the heck out of Dodge.
Dr. Patterson helps Sasha walk to the car using a towel under her belly to help stabilize her. It’s time for me to lift her into the back of our Jeep, but I am so scared of hurting her. With my right arm under her belly, and my left hand contorted under her chest to keep as much pressure away from her right side as possible, I hoisted her into the Jeep. I carefully climbed in the back with her so that I could keep her from getting hurt during the short ride home. Sasha is happy to be with her family again, but there is no disguising the fact that she has been through a traumatizing experience. It will take time for her wound to heal, and for her to learn to be a three-legged dog. I will continue to chronicle Sasha’s road to recovery from the surgery, and her battle with cancer.
When I wrote my last post/entry, Liliana and I had just learned that our eleven year old American bulldog, Sasha, had a tumor on her right humerus. Our vet, Dr. N., and Dr. Clary, an orthopedic surgeon, agree that the tumor is likely the result of a type of bone cancer called osteosarcoma. After speaking with Dr. N., and doing extensive research on canine osteosarcoma, Liliana and I decided that the best course of action would be to amputate Sasha’s arm. We did not believe that Sasha was ready to leave her family yet. She is very healthy aside from the tumor, and she acts younger than her age. Immediate amputation of the affected arm was the advice given to Liliana and me by both, doctors N. and Clary. Their advice was consistent with the accepted course of action of all similar cases that I was able to read about on-line.
We brought Sasha into the vet’s office on Tuesday for some final X-Rays to make sure that the cancer had not visibly metastasized into her lungs, and to have a fentanyl patch applied to her neck for pain management. I was so happy to see that the radio-graphs showed no signs of additional cancer. Unfortunately, just because no tumors were visible in Sasha’s lungs, does not mean that they are in fact clean. Apparently, osteosarcoma does metastasize in 90% of all dogs that present with a tumor. I am just glad that the cancer has not progressed to the point where it is actually visible in her other organs. I will write more posts in the future to cover Sasha’s continued battle with osteosarcoma post amputation.
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.