Month: April 2018

The pups and I were out of town visiting family for our annual celebration of my nephew’s and my birthdays.  I’d spent a couple of days since the news of biopsy results doing some research and looking into the objective data surrounding amputation, chemotherapy, and radiation.  It had been a rollercoaster week emotionally, to put it mildly.  At times, I was leaning on my clinical knowledge (though it is limited to 20 years of experience in EMS, which is almost exclusively focused on pre-hospital medicine of human beings); and just over 20-years experience as a dog dad.  Other times, I was a sobbing mess, anything but clinical, anything but objective. I was just a dog-dad, and one of the best friends I’ve ever had was facing something that I wouldn’t wish on my worst enemy.  What’s more is that he was depending on me to do the right thing.

The first pup that I experienced as an adult was an American Pit Bull Terrier.  By the time she was four-years-old, it was already a few miracles that she was still alive.  One time, she got hold of a bottle of Tylenol.  Ate the whole thing, including the plastic; and I guess puked most of the whole thing up, including most of the plastic.  Once, we were playing outside when she jumped to grab a stick out of my hand, and impaled herself in the abdomen with the remnants of a tree trunk.  Another time, she got hold of a bag of flour off the countertop.  She ate half of it, and tracked the rest of it all over a 2000 square foot house.  Carpeted.  It was not pretty for the next 24 hours.

With that pup, even at the slightest sneeze, cough, or shiver, I was the over-reactive first-time-dog-dad.  I joke with my vet that I insist his daughters do well in college, because I am the one paying their tuition from all the visits that I made to him with Ms. Coco.

By the time Roscoe came around nine years later, it was old hat.  Blood in a puppy’s stool?  No problem.  It’s normal.  Walk it off.  Hives all over the body?  Pfft.  Child’s play.  Give him a dog dose of Benadryl, make sure it’s not multi-systemic, and let the vet know about it on the next routine visit.  Vomited after eating grass?  Yeah.  That’s what’s supposed to happen.

And then came the slap in the face….

When I got the news that it was most likely cancer inside Roscoe’s leg, it was a whole new ball game.  I was in stormy and uncharted waters, caught totally off-guard.  My mind was reeling for days.  Still kind of is.

“It could be an infection, like a fungal infection.  It could be something less aggressive than osteosarcoma.  But four of us (veterinarians) have looked at it independently, and we are unanimous in our primary impression,” Dr. Hodges said to me over the phone.

Just under a week later, a biopsy was taken.  A few days after that, histology confirmed it as a sub-type of osteosarcoma.

A little bit of research led me to the conclusion for our circumstances that amputation was what made the most sense, given the information at hand.  If we left it alone, we ran the real risk of a pathologic fracture.  That would mean emergent amputation, with progression of malignancy beyond where it was now.  It seemed (and still does) the only reasonable option.

I called the clinic on a Friday.  “We’re gonna go ahead with amputation.  What is the soonest I can get him in?”  They were words I wouldn’t wish on anyone.

Six days later, I dropped Roscoe off at the clinic for the procedure on a Wednesday.  I didn’t know it at the time, but it would be the following Sunday before I would be able to see him.

A coworker offered this advice, when I told him what we were going to do, “I know how you are.  You are going to question this later.  Don’t second guess it.  You are doing what you know is right for you guys.  If you start wondering in a few days or weeks if it was the right thing, remind yourself that it was the right thing based on what you know.”

That is sound advice for anybody faced with doing something when the options seem limited.  Do the right thing, and trust that it is the right thing; whatever that thing is.

 

At the beginning of February 2018, Roscoe came in from outside with a limp.  It’s not the first time he’s limped.  He sometimes has allergies, sometimes tears a pad, and often gets a bit rough with his adopted sister, Hazel.  I thought nothing of it.  I checked his paws, and there weren’t any tears or abrasions.  I figured he and Hazel were rough housing in the backyard.  No big deal.

A few days might have passed before I noticed the limp again.  Again, I checked him out.  Again there was no outward sign of trauma.  Again, I figured it was Hazel and Roscoe playing too roughly, so I started to accompany them on their backyard ventures.  Sometimes he limped, sometimes he acted just as normal as always.  Being that he’s 11-years old, I considered he may be getting arthritic.  He is a bit overweight (dogs favor their owners), and for the last couple of years, I’ve had to park next to a curb for him to be able to make the two-foot jump into the car.  None of these differential diagnoses was a stretch, in my paramedic-trained mind.  It all was just a natural progress of canine aging, I figured.

The limp seemed to subside for a week or so before I noticed it again.  I wondered if it might be a sprain that was poorly healing, and called to see if my vet was in.  He was out on medical leave.  I called back a week later.  He was still on leave, expected back in the first week in March.  I booked an appointment with one of the other vets, since the limp was now fairly persistent.

I dropped Roscoe off in the morning, as is often my M.O. with vet visits, expecting to hear something by mid-day.  After noon, I called to check on what the vet had to say.  “I really would rather have this conversation in person, but it’s not a sprain.  There is something showing in the X-Ray on the neck of the proximal humerus (part of the forearm closest to the body).  It could be something relatively benign like a fungal infection; or it could be something more serious, like a cancer.  Come in when you get off work and we’ll talk.  I’ll send you a copy of the images so you can see what I’m talking about,” she said.

The biopsy was scheduled for 21 February, followed by a week of waiting for word from Texas A&M histology.  The biopsy came back as some kind of malignancy.  The likelihood of osteosarcoma was now more certain, although not definitive.

I was scared.