Pain management

If it's possible, I think I love my vet even more! She called me just now and said she's working up his pain management plan. She said she's all about some pain management and there's so many new things out there that can keep them out of pain and it's better to prevent the pain than to try and treat it once they're in pain.

So the new plan is for him to stay there Friday night too and I'll pick him up Saturday...the pain patch they put on Wednesday only lasts 3 days so this will allow them to put on a second pain patch Saturday morning before I pick him up. Also they can keep an eye on him just a little bit longer. This actually makes me feel better since the specialist had planned to keep him through Saturday also. Even though I'll miss him like crazy, I feel better about him being there with the experts.

Also she said there are some optional pain meds (muscle relaxers, etc) that she can prescribe that she highly recommends so I said yes to that too...they cost about $75 and will have to be picked up in Winston. She said "phantom pain" is very common and also there can be a lot of muscle pain from the muscles being cut and also the muscles trying to adjust to the fact that the leg is no longer there.

I'm really happy with my vet - she really seems on top of things!!

Thoughts on amputation

Some of my earlier posts don't really reflect my struggle with deciding on amputation. I was trying to be positive at the time so wasn't really expressing my thoughts about that. I wanted to go ahead and talk about that now.

Coming to the decision of amputation has been very hard. It sounds awful and everytime I look at his little leg, it makes me sad. One thing that helped me was reading stories online from people whose dogs had the exact same type of cancer in the same place and they decided to have the leg removed. I also read a lot of information online about this type of cancer - even prior to having the consult at the specialist - the idea of amputation was in the back of my mind I was slowly adjusting to it - this made my final decision much easier. Also I googled "dog + amputation + recovery" and read through MANY of the websites that came up. It is truly amazing how well the dogs recover. Both my vet and the surgeon reassured me that they recover SO quick from it. It's a routine surgery and will actually be pretty easy on him. The bottom line from my perspective is that it guarantees that the cancer won't return! I'm not going to let this evil cancer take my baby from me and this guarantees that it won't!

The other alternative (tumor removal) has about a 40% chance of the cancer coming back. That seems like such a risk to me. And the recovery from that surgery would be so difficult. I can't imagine how hard it would be to get that area to heal since it's on his elbow.

My main concern in making this decision is guaranteeing it won't come back and also giving him the easiest recovery. That's what led me to decide on amputation.

The cost factor - $650 to have his leg removed (at my vet). $3000-$4000 for tumor removal at the specialist (regular vet isn't comfortable doing that)

During my consult with the specialist, he said that the course of treatment is really dependent on how far I want to go to save the leg - I responded that I don't really care about his leg, I care about his LIFE! I don't mean that in a harsh way. But I want him to live and be with me as long as possible!

My boss had a good comparison about this. When people have cancer, they often have different options for treatments. Some people choose to be more aggressive, some people don't. He compared it to breast cancer - some women decide to have both breasts removed due to a tumor in one breast instead of having a lumpectomy. I can totally understand. If I had cancer, I would be very aggressive with treatment. My mom died of cancer when I was in high school so I believe in aggressive treatment as early as possible.

Also I've found talking to people has really helped me. Talking to my girlfriends and friends at work has made me feel like I'm making the right decision. It's nice to have the support of others!

I know some people may not agree with my decision. But this is my decision and I feel totally at peace with it. There is no doubt in my mind that this is the right thing to do. Many tears have been shed over the past week or so. This decision has been very tough. But I can just feel that it's the right one.

Sorry for the rambling post. Hope this helps to understand how I came to this decision.

I hope this post doesn't receive any hostile responses. Please understand this is a very personal choice and it's my choice to make.

Decision made (7/9/08)

I decided to start this blog on 7/11/08. I didn't want to go back and tell the story...just wouldn't be the same as what I was feeling at the time. So I'm coping these older posts from several emails I sent to my best girlfriends.
This is from an email I sent the evening of 7/9/08:

The chest scan was clear so the cancer has not spread. I talked to both the Internal Medicine doc and the surgeon late this afternoon. They didn't exactly suggest which way I go with this but I felt like by what they were saying, they were in a way suggesting the best alternative (hope that makes sense).

Since radiation is not an option because I can't afford it, that leaves 2 options.

1. Based on the surgeon's opinion, they can attempt to remove the tumor and estimate a 40% chance of recurrence. If I go that route, the area will be large because they have to remove the surrounding tissue. They don't do skin grafts in dogs but they do something similar called a "skin flap"...that would cost $3000-$4000. It would be a difficult surgery and recovery. If the cancer comes back, at that point, there won't be much tissue left so amputation would likely be the only alternative. And if the cancer does come back, it's possible that it could spread somewhere else like his lungs or chest cavity.
2. The other option would be amputation - which would pretty much guarantee the cancer won't return. It would cost $1500-$2000 and would likely be at the lower end of that scale based on his size. I talked to the surgeon at length about this and she said it's a very routine surgery that rarely has any complications. Dogs adjust very quickly and are normally back to completely regular activity in 3 weeks or less. She said it's amazing how quick they adjust and recover. She said her take on it is that "god gives dogs 3 legs and spare" - that made me feel better.

So I made the decision to have the leg removed - I want to save his life and give him the best and easiest recovery. That's what my gut is telling me to do. I feel at peace with my decision.

I could have it done tomorrow but I don't feel quite ready yet. So I made the appointment for next Thursday and I should be able to bring him home Saturday. I will be able to visit him twice a day for 30 minutes for as long as he's in the hospital. Him and Gidget will need to be separated when I'm not home (for a few weeks) but he'll be fine being left by himself. He'll be able to walk and get around immediately. She said in about 3 days, they adjust to it and are able to walk around fine. She suggested I get him some cute clothes because it's often upsetting to the owners to see the area.

I ended up talking to a lady on another message board I'm on and she's a vet. She said she's been involved in many amputations and the dogs do very well immediately. She said once they wake up from the anesthesia, they have all been able to get up and walk outside to potty. She said it's like an instant adjustment.

Unfortunately, my normal vet can't do the surgery (they only have one doc that does this and he's out because of a broken leg and they don't know if he'll return). So I'm having the surgery at CVS (the specialist)...meaning I'm paying a lot more than I would at a vet. But I trust them and got a really good feeling from them.