May 28, 2012: One week post amputation means a trip to the park

It doesn't get any better than this - a trip to the park!

Happy Memorial Day!   Arri celebrated his one week Ampuversary by taking a trip to the park.  Nothing is going to hold this dog back.

The bruising is getting much, much better.

May 27, 2012: Arri's first excursion

Every day Arri is moving with more comfort and grace.  I think once we get back to taking walks, I will have to be jogging.  I never walked fast enough for him and his balance is better the faster he goes.  I read about this happening and so far, Arri is proving it to be true.

Today is Arri’s first outing since surgery.  We are going to (his) grandma’s house.  He loves grandmas.  There are dog treats, soap and tissues in the trash.  Tim lifted him out of the van and Arri headed straight for the door – making a brief pit stop to water the hosta.  Sorry mom. 

 In all the excitement, he forgot that going up steps are a challenge.  Grandpa opened the door and Arri hopped right in.  Unfortunately for him, there were no carpets.  The inside is undergoing a fresh coat of paint so all area rugs have been rolled up.  There was a little slipping but that didn’t stop him from exploring.   

From there we went to Uncle Dwight’s to drop off some cupcakes and say hello to everyone.  We didn’t take the dogs inside (Oregon was with) but chatted in the yard.  Arri roamed around and peed on stuff.  Oregon met cousin Maggie – a Saint Bernard.  He didn’t seem as impressed as the other pups have been.

We left to go home, driving past Grandma’s and saw Uncle Darryl and family were visiting.  We had to stop and say hello.  (Grandma and Dwight only live a block apart)  By now you may have figured out that I am just driving around showing off Arri.  Oddly enough, seeing him on the move is a lot more convincing that he is doing great than just telling people.

While we were out and about, I noticed a swelling on Arri’s thigh; a couple of inches above the incision.  It feels squishy, like fluid build -up.  Naturally, it is a holiday weekend and no one will be at the doctors tomorrow.  I will keep an eye on it and hope is goes away on its own.

May 26, 2012: day 5 in (poor quality) photo

 Sorry - professional videographer I am not.  I will stick with cake decorating.  The images are out of focus and jumpy but you get the idea of the incredible progress Arri is making. This is only 5days after amputation.

Starting to run

Starting the long walk around the house after finding his way downstairs but not being able to climb back up.

 

Starting to show real interest in playing

Just chillin' after a long walk around the house

Dinner time!!!

May 26, 2012: honest, it has only been 5 days since amputation

I had to drag Arri off the bed because he didn’t want to get up.  Then he didn’t want to go out so he missed the first opportunity.   He is mobile enough now that when he needs to go out he can go to the door.  I offer 50 times a day and he will take me up on maybe 3 of them.  After breakfast, he needed to go out.  The step out intimidated him again but once past that he hopped to the grass and peed.  His travels this morning were a bit like the kids in the Family Circus comic.    He hopped to the driveway and traveled ¾ of the way down, cut into the grass to toilet.  Hop to the middle of the yard to sniff and mark over where Summer peed.  More hopping away from the house to toilet again and finally he was done.  He ran to come back inside.  His gait was much smoother the faster he went.  I was so disappointed that I didn’t have the camera to record his first run.  While he may have felt much lighter, he was quite tired and breathing hard.  He hesitated going up the steps but I put the sling under to give him a confidence boost.  I think he is starting to understand that the sling means his leg won’t collapse if he tried to jump.

So it is Saturday and it is wedding season.  That means I am making a number of trips from the bakery up to the garage.  I moved the baby gate out of the way so that I don’t drop any cakes while going up steps and moving a gate while carrying a cake.  At one point, I stayed down stairs but did not put the gate back up.  The next thing  I see is Arri’s face at the bakery doorway.  To say I was stunned is an understatement.  Completely ignoring Doctors orders, he went down 14 steps.  I never heard any crashing or thumping so he must have been somewhat graceful in doing so.  My next thought was how on earth am I going to get him back upstairs?  We will have to go out the bakery door and around the house.  A fairly long walk compared to what he has been doing, but the ground is a gradual slope back up to the first floor.   He tries to jump up on his sofa so he can assume guard duty but misses.  His back leg gives out.  So I lift him up and he settles in until he hears me say “all done, I quit for the day’.  That is his signal that we leaving the basement for the day.  If I don’t say it, he will just stay on the sofa waiting for me to come back downstairs and go back to work.  Arri has to stop and rest twice on the walk around the house.  The last time, I put the sling under him as he was breathing hard and getting tired.  Or so I thought.  As soon as the sling was under him, he started moving so fast I had to jog to keep up with him. 

One of Arri’s favorite things is to go to the park.  Arri is grounded from the park until the incision is healed and he is confidently moving around the yard.   When I ask him if he wants to go, I get no reaction.  He knows I am not the one who takes him.  When Tim says it, Arri runs to the door to the garage.  The trips are only 15 minutes or so but that is more than he can handle right now.  The other day, I explained to him  that he needed to be moving in the yard better before he can go back to the park.  I think that is why he is running now.  He wants to be ungrounded.

He is moving so quick now, I can’t get the video camera up in time.  Stinker.  After dinner, he successfully managed the stairs down and up (with a little sling support)  His bruising is looking better.  It is starting to get lighter and change colors.  I was very surprised to see he is bruised all up his rib cage to his front legs.  It doesn’t show in pictures because that part isn’t shaved. 

Arri is lying on his left side more.  This gives me a chance to massage his right rear leg.  It is getting more use so I imagine it gets tired and sore.  I know mine would.  I am also massaging his back often.  From what I have read, to balance himself, Arri will move the back leg to be more centered with the body.  Doing this will change how the muscles position with the spine.  There may be some back soreness from the new muscle work.

Oh, and Arri’s Rough Wear harness came today!  Now to get it fit.  I knew this would be the tough part.  He doesn’t want to stand while I figure out the right fit.

You know you do too much mail order when you see the Fed Ex truck pull into the neighborhood and you and your husband both say, I bet it stops here……and it does.

May 25, 2012; a quiet day

Arri can now get out of the house, going down one step.  He still does not have the strength to bounce his back end up the step.  So today we threw Arri a curve ball.  To make the step outside easier on him, Tim picked up some large landscape tiles.  We turned the single large (9”) step into 2.5 shallow steps.  I never would have guessed this would have made life so difficult for Arri.   Now, he doesn’t seem to be able to go down but he can go up.  The blocks are light grey so maybe the color is throwing off his depth perception.  Oh well.  We will get it figured out eventually.   As quickly as he is adjusting, he will be fine tomorrow.

May 24, 2012: Post amputation day 3

My eyes are brimming with tears of pride at my boy.  He is just incredible. 

Let’s back up a bit.  Remember that ban of sleeping on the bed.  Yeah, well, toss it out the window.  I climbed into bed and Arri started pacing and bobbing his head.  He wanted to jump and it was just a matter of time before he tried.  Yes, I caved.  I lifted him up onto the bed.  I figured, if a single step intimidated him, he would not try to jump off the bed.  I felt him shift a few times but he stayed with me. 

The first moment of pride:  I pulled Arri to the edge of the bed and let his front legs slide off – similar to getting him out of the van.  I stabilized the back while he managed the front.  As he stepped forward, I guided the back leg down.  From there, Arri needed no help.  He barreled through the house to the front door.  I got there before him and opened it.  No hesitation what so ever.  He went down the step to the grass, peed, turned around and headed back to the door.  He waited for me at the door.  Going up still requires a little ‘leg up’.  I put the sling under his belly and wait.  When he is ready, he puts his front legs on the step while I support and lift the back and he steps forward.  Once his back leg is on the carpet, I drop the sling and he goes where he wants.

Today might be interesting now that Arri is growing in confidence and ability.  Tim worked night shift so he gets home at 6 am and goes to bed.  Typically, Arri will eat, toilet and go back to bed with Tim.  The problem is that he will jump on and off the bed during the day to check on me.  I get out of the shower to find Tim had lifted Arri up onto the bed.  Ok, we will just roll reverse, I will check on Arri today.  Into the office to play some games before heading downstairs to the dungeon – I mean bakery.  After 5 minutes, Tim comes in and says – ‘so much for him not jumping’.   Here is a moment of pride, terror and a few new grey hairs.  I say – ‘you helped him right?’  Tim:  ‘no, he didn’t give me time, he just jumped’.  Tim said he didn’t fall or stumble but landed, got his balance and kept hopping.  Good grief.  I can not believe I was ever even slightly worried about how Arri would respond to amputation.  This dog is a NUT.

I am going to have to baby gate the stairs to the basement.  I suspect he will try to come visit me in the bakery today.

The bruising is worse still.  Arri is bruised in areas I had no idea would get bruised.  It is like it is traveling up his belly.  I did send photos to the doctor to make sure this was normal and I was told yes.  All is well and to keep using the dry hot packs.

Youknow you are REALLY a dog person when you take photos of your dog's nether regions and post them on facebook without a second thought. My mom is probably rolling her eyes and wondering why I don't have girl dogs : )

May 23, 2012: Post amputation day 2

Some things I left out from yesterday.

The incision is roughly 9 inches long.  His bruising got worse as the day progressed.  I am hoping my ineptitude with the sling did not cause even more.

I am looking forward to getting Arri’s harness.  He can wear it all day and I can grab on when he needs help.  I don’t have to chase around with the sling.  I think sometimes he sees me coming and thinks ‘drat, why won’t she leave me alone’.  We have only been doing this for a day and he is already giving me that look.

I was warned that it will be a rough couple of nights.  Honestly, I think Summer was worse on Sunday but last night was not fabulous.  Arri sleeps on the bed with me.  He is not allowed to jump right now and even if I lift him up there, he will not wait for me to lift him off so he is banned from the big bed.  This led to some pacing on his part.  In the end, I moved to the floor but by midnight, he still couldn’t settle in so I climbed back in bed where it was warm.  I bought him a nice bed that is similar to the mattress but he would not sleep on it. Oregon loves it.  Sigh

At 3:30 I woke up to the sound of licking.  I really hate that sound.  It will wake me up every time. It doesn’t matter what body part is being cleaned.  Arri was in the doorway licking in the vicinity of the wound.  I started the ‘do you need to go out?’ game and he gave me the blank stare with a slight wiggle of the tail.  After 5 minutes of this game, I crawled out of my warm, snuggly bed to see what the issue was.  The answer?  No he didn’t need to go out but I needed to get the carpet cleaner going.  I guess a treat of canned dog food wasn’t a treat at all.  At least it smelled better than Summer barf…if you can believe that. 

A  little after 4 am, I made everyone go out.  If I had to be awake so did they.  They happily took care of business.  The single step in and out of the house is still kicking our butt.  Arri made it to the grass without stopping and was ready to turn around and get back inside.  We are having some issues with the other dogs in the house blocking the way. 

Arri ended up in the inflatable e-collar after licking last night.  He looks miserable.  He did have a little bloody discharge this morning but it has dried up.

I have taken the day off work, mostly.  No baking.  Just paperwork and phone calls.  Since Arri likes to hang with me in the office, it works out well.  Today is such a beautiful day that we take a book and sit in the yard enjoying the sun and breeze.  The ulterior motive is to get him to go to the bathroom.  He has been having toxic gas releases all day but nothing solid.  Yesterday we were celebrating poop, today we are begging for it.

He is really moving much quicker.  He tires after only a few feet but that is pretty amazing.  I purchased a few more carpet runners this morning and now he can confidently  maneuver around the whole upstairs on non-skid floor. 

Tim was on duty while I went to the grocery store.  Arri barked and greeted me at the door as though nothing was different….until Oregon pushed him over.

The bulk of the drugs are out of his system.  His eyes are bright and when I sat to tell him a story, his ears perked up and his head cocked from side to side as though truly interested. It was a story about a 3 legged dog that barked at the door to go outside to potty.  Arri thought I was telling a fairytale.  His old self is back.

6:00 pm.  Time to get Arri outside to toilet.  I had to force him to stand and prod him to the door but once he got moving, he didn’t hesitate.  I didn’t have to do anything to get him down the step.  Wow.  Let’s hope that wasn’t a one time try.

I was right.  Arri is a lefty.  He keeps trying to lay on the missing leg.  Tonight he managed it.  Once in position, it must be ok, but he is going to hurt when he tries to get up.

May 23, 2012: Day 2 post amputation in photos

Busted for licking

The bruising is much worse today

Relaxing in the sun

Only the second day after amputation

Did someone say dinner???

May 22, 2012: Amputation day 1

9am, taking Oregon for his vaccine and getting Glamis weighed.  We are celebrating!!!  Glamis is now just 2lbs away from his goal weight.  Nine months ago, G weighed 109 lbs.  Today he was 82.3.  On the way home from the vet, we get the call from the surgeon that Arri can come home.  We arrange pick up for 12:30.

When I arrive, they put me in the comfort room.  We go over the surgery, medication, restrictions and post surgical care.  Arri will get Tramadol and Deramaxx for pain.  He has no stapes or sutures.  I am to watch for swelling and discharge.  There is some bruising.  I am to use a hot pack (dry heat) on the incision about every 6 hours. Considering the significance of the surgery, there is very little I need to do but let him rest and heal.   In answer to my question about the lymph node, it was sent for biopsy as a precaution.  That is a load of worry off my shoulders.  Time to bring Arri in.

I hear his toenails on the tile and it makes me smile.  When he enters the room, there is no excitement to see me, no tail wags.  The boy is stoned.  Unaware I am in the room.  He lays on the carpet and I get a look at the wound.  I can't explain what I was picturing but reality is different from what I thought.  Not nearly the bruising she prepared me for.  I thought it would be worse.  There was also less leg than I expected.  I pictured a good portion of the thigh remaining.    Maybe when the fur grows back it will look more like I thought.  Speaking of fur, he has an interesting hair cut.  We just sit for a bit absorbing the change.  Doing all the research and preparing myself for the moment has helped tremendously.  When I see him it is more like seeing someone with long hair chop it off into a pixie.  It is different and will take some getting used to. 

Next is the hard part; getting him to the car.  I don’t know how to use the sling yet.  Yes it is basic but how much pressure is too much.  He is not excited for the walk.  He could care less if we ever make it to the car.  I can’t be in front of him luring him while holding the sling in a good place.  So we hop once or twice and sit.  Hop and sit.  We get to the van and I just stare at the opening.  This is going to be interesting.  I can lift him but he does not like that, never has.  If I put his front legs in, his back is really too weak to hop.  At this point I am not sure how I did it but either way, he was in. 

The trip home was quiet.  No crying, panting, coughing.  It was nice not to be stressed the whole trip home.  We stopped one time and I pulled Arri out of the van.  I pulled his front legs to the edge and let him slide forward.   Now, you have to understand that I drag my dogs from the time they are little puppies.  They will lay on the floor and I will grab two legs and spin them around.  This usually happens during toe nail trimming.  If I am taking photos and I want them in a certain place, I will drag them there.  It is easier than trying to get him to move 4 inches.  They trust me in doing this and never fight it.  While he was sliding I lifted on the sling and handled the back end.  It wasn’t graceful but it did the trick.  A couple of hops with help to the grass and I dropped the sling.  He sat, then stood and took 3 hops and peed.  I was so excited.  A little rest and back into the van.

When we arrived home, I parked right at the edge of the grass so Arri would have a soft spot to land.  His confidence is shaky so we do a lot of stop and start.  He moved around a bit and peed again.  Since it was dog dinner time, we tried to encourage him into the house.  He just stood.  I let him take it at his pace.  Next thing I know, he is hopping away from the house.  He goes about 15 feet and squats to poop.  That about knocked my socks off.  He did it with no assistance.  Ok, I know it isn’t a miracle.  It is just that most literature talks about constipation and concerns about toileting.  In going through all this, I should know that Arri plays by his own rules.

We introduce the other dogs one at a time.  Tim had laid out the carpet remnant on the kitchen tile for traction.  Arri is just laying there.  First up is Glamis.  He comes pouncing out in happiness, gives Arri and sniff and moves on.  Next up is Summer.  Her reaction is fairly similar.  Finally it is Oregon.  He pounces on Arri’s head and starts licking his face.  Then he works his way back to the incision and gets a little too nosey.  Arri does not complain but I make him back off.  That went well.

Dinner is a special treat of canned food.  The doctors said this was not necessary but I could if I wanted.  I wanted, so I did.  I put the food between his feet and let him eat laying down.  By next week, he will be at the elevated food bowl again.

I can tell he wants to move but is unsure of himself.  At the same time, he doesn’t like the sling too much.  He is doing a bit of grunting like there is discomfort.  I just need to wait him out.  He will relax when he is ready.  He moves himself in front of the door to watch out the window.  Summer and Oregon go outside but he does not want to.  When Summer comes back in the house, she steps right on Arri’s incision.  I about died.  She found herself 5 feet away from Arri and wasn’t sure how she got there.  I know how but I’m not telling.

Arri was finally motivated to go out.  It is a bit of a walk from the front door to the grass so he toileted as soon as he reached the grass.  While he rested up, Summer and Oregon wrestled in the yard.  Getting in and out of the doorway is difficult.  We will figure it out with more practice. 

At this point I think we are in for the night.  I leave Arri to rest in the living room and go into the office to play on the computer.  About 4 minutes later, I hear him.  He is working his way down the hall (need to buy a temporary runner).  He loses his footing ¾ of the way to me. I let him lay for a few minutes but I know he can’t get up.  The floor is wood and too slippery to get his back leg up.  I grab his front legs and drag him to the carpet.  He gets his legs under him and finishes up the walk to where he wants to plant himself for a while.

May 22, 2012: Day after surgery in photos

Resting after a potty break

In the car - leaving the cancer clinic

Canned food for dinner is a treat - carpet remnents on slippery surfaces.

A graphic view of the surgery site

Not his first steps but this is the day after surgery. 

May 21, 2012: Surgery day!

May 21, 2012

Everyone sing with me….doo do do doo do, dooo do dooo do do.....Oh what a night…late December back in ’63……

Yes, it was quite a night. Knowing I had to get up at 5 am, I tried to go to bed early, just as a thunderstorm was starting.  Normally I can sleep through thunder but this storm was distracting.  I finally fell asleep forgetting to put Oregon in his kennel.  (Tim was still up).  I wake up a little before 11 and find he is next to me on the bed.  With the help of a cookie, Oregon goes to his kennel.  10 minutes later I hear him scratching at the floor.   I turn on the light to make sure all is well and he is sitting up with his paw raised as if in question.  I get up to check and don’t see anything but then I smell it.  Lake Oregon had been absorbed by the carpet mat in his kennel.  I tell him that raising his paw in the dark will not get the necessary attention to get the kennel door open.   The storm was still in full fury so Oregon got to hurry in the rain.

Fast forward to 1:30 am; It is still storming.  Golden girl Summer does not like storms.  She quivers and shakes and tonight or should I say, this morning, she chose to be sick.  She had been quivering at Tim’s head and managed perfect placement between the mattress and headboard.  She nailed the sheet, headboard, both mattresses, the wall and floor.  It was also one of the most foul smelling things.  The cleaning begins and there is not nearly enough Lysol and the Febreeze is MIA.  Summer ends up in a kennel for the rest of the night.

Fast forward to 4:30 am.  Still raining but the storm has passed. I think I slept a bit.   Summer is once again sick in the kennel.  This one was much easier to clean up – Thanks Tim!!!!  I had 30 minutes left to sleep.

5:00 am  When I exit the bathroom after showering, I see lights are on, all dogs are up and Tim is dressed.  What’s up??  While I was in the bathroom, Summer was barking at the front door to go out.  Boy that girl has issues today.  I really hope Tim can get some sleep today as he has to work tonight.  That is one good thing.  He does still have time to get some zzzz’s.  I, on the other hand have to load up the car for Operation Arri.  I should mention him since this is supposed to be about him. 

The final photo before surgery 5.20.12

We arrived at the clinic in good time without driving though rain.  Arri was happy to be there, as always.  He weighed in at 57.6 lbs.  After talking with the surgical tech, reviewing medication and getting a little insight about pick up and follow-up, Arri headed to the back room.  He walked so nicely to ‘THE DOOR’ and once it was opened, he started pulling to the back treatment area.  What a goof.  It is a rare dog that gets excited about getting stuck with a needle, poked, prodded and drugged.  Maybe it’s all about the drugs.

Let the waiting begin…………..

5:04 p.m.   Dr. Walshaw finally calls.  Ok, so this was the time I pretty much expected him to call but I can always hope Arri wasn’t the last surgery of the day.  Arri is doing well, resting comfortably.  The surgery went well.  They won’t send the tumors in for biopsy because they know what that is but they are sending in a lymph node from behind the knee to check.  I am not sure if it was suspicious or if this is precautionary to verify the cancer had not spread.  I will get clarification tomorrow.

I seriously hope the song ‘oh what a night’ leaves my head soon.

May 15, 2012: Beach day!!!

I had to take Arri to the beach today.  It was such a nice day and it will be awhile before he goes again.  I don’t want sand in the wound and learning to walk will be tough enough.  Once he has his balance down, we will try sand.    I could tell my boy has aged.  He used to drag me across the sand to get to the water.  Today, he pulled a little.  Once he saw the water, he pulled a little more.  He also did not jump right in.  Ok, so the water was pretty cold – only 60 degrees but that never stopped him in the past.  He would swim with ice on the water if I let him.  He went in and out, spending more time on the sand rolling.  Another change.  There was a time when he would enter the water and would not get out until I bribed him with treats or went in the water and dragged him to shore.  Some days I thought he would swim to Chicago.  He just kept going deeper and deeper.  

May 9, 2012 Chemo begins again

We got the call to go ahead with chemo.  Arri will take Cytoxan once daily.  There are special rules for handling and storage of the medicine.  You must wear gloves and store them in a hazardous waste bag when not in use.  We can reuse them.  If the pills touch a food surface (counter) you have to wipe down with alcohol, then soap and water, then rinse and dry.  All stool must be picked up immediately since we do have other dogs, some of which try to help clean up the yard.  If we were to continue with this treatment long term, blood tests would have to be done monthly.  Side effects may include: nausea, diarrhea, vomiting, loss of appetite, low white counts and bladder irritation.  We are to encourage water intake and exercise.  We are also to watch for blood in the urine or straining to urinate.  I will have to remind Tim to let me know if he notices any of that.  These are things he may notice when he takes them to the park but never mention to me – until I bring up the concern.    Arri is not big on drinking water so we have always added it to his food to ensure he is getting some.   We will have to add a bit more.

May 7, 2012 Photo day

Another visit to the vampire.  We cannot start the metronomic chemo until the blood count is good.  Dr Mike asked why they didn’t do chemo last week.  He didn’t see any number that was out of the ordinary.  His white count was low, but it was actually higher than the first chemo treatment.  I could not remember what code they said was low.    Arri and I waited for the test results and his white count was up.  The data will be faxed to the oncologist and when she gives the word, we will start the daily chemo pills.

Photo day!!!  Let the chaos begin.  We are taking all 5 dogs to a photographer to get GOOD photos done. This session is to get a group shot, singles of Teva before he leaves for school, Oregon’s puppy pictures and the last photos of Arri on all 4.   You would think these dogs have never gone out in their life.  Never mind all the socialization and experiences they have had during their CCI training time.  They just get SOOO hyper when in a group.  One or two at a time, you would think they were different dogs but get all 5 in a room that is new to them and chaos reigns.  It really is no wonder I try not to torture the same photographer twice.

I am fairly certain there were only 5 working brain cells during the dogs photo session -   All of them being contained in Teva’s head.  He held his positions and stayed in place.  He didn’t move at the goofy noises.  He did great with one exception.  When it was time for Arri’s solo shoot, Teva wanted to be with him.  He kept running into the shot.  I finally lured him away and told him to sit.  He did.  Right on the photographer.  Kevin was laying on the floor to get the photo and Teva sat on his back.  Laughter and chaos go hand in paw.

May 6, 2012 Random musings



At the base of the bare skin, is the darker fur

Now that Arri will be losing his leg, I look at it all the time.  I try to picture him in the yard as a tripod.   I watch which way he leans when peeing – gotta have one foot an inch off the ground.  I note which hip he prefers to lay on.  I think I would have to say he is a ‘left footed’ dog.  That is a bummer because that one is going away.  Another interesting thing is that the hair is starting to grow back and I really would like to see how it turns out.  It won’t grow fast enough to know for certain.  What am I talking about?  When I researched radiation, I had read about how it is not uncommon for the fur to be a different color when it grows back.  All of the examples were dark animals with new white patches.  As light colored as Arri is, I did not expect to notice a difference.  The funny thing is, it is A LOT darker.  Arri is very light/cream colored.  His darkest hairs are still sandy.  The hair coming is in caramel colored.  What can I do but take more pictures.  Yesterday I took a bunch from the rear – just his two back legs in a side by side comparison.  Tomorrow  we have a photo shoot to get a nice photo of all 5 dogs before Teva leaves for advanced training and Arri has surgery.  I didn’t really want to delay surgery but once Teva is at school, one less dog will be a bit easier. 

Odd things run through my mind.  I am so glad that I struggled but kept trying to get the right food for Arri.  For 10 years we battled with his weight between 60 and 70 lbs.  I knew he looked best at 60 but keeping him there was next to impossible.  I tried 4 or 5 different foods.  They would take the weight off but I could never find a portion size that would maintain him.  He was a constant yo yo.    1.5 years ago, I tried Pro Plan Shredded Chicken Weight Control.  It was amazing.  The extra pounds dropped off him and it only took a month to get the right adjustment for maintenance.  All through this illness, he has been a steady 57 – 59 lbs.  Not having the extra weight will make it so much easier for him.

Naturally, with all that is going on you would think I wouldn't have time to work.  Sadly, that just is not true.  My customers would not be happy if I called and asked for a few more days.  I officially entered my 'busy' season two weeks ago.  I am up to my elbows in cake and icing.  This weekend alone, I had 4 wedding cakes.  It is very hard to say no to my customers but over the last few years I have gotten better.  They are going to be really upset when they learn I am not going to take any more cakes for the next month - prime graduation time.  It is not unusual for me to work 14 - 16 hours on Wed - Fri to get ready for the weekend.  I just won't be able to do that while Arri is in recovery. 

May 3, 2012 Contemplating surgery

 It has been two days of non-stop thinking.  Me, myself and I are not sure what to do next.  Somewhere in there I also ask Tim what he thinks.  Logically, I know surgery is the way to go.  Emotionally, I don’t want to mutilate my boy.  I don’t want to see him in pain and struggling to learn to walk on three legs.  I know there are lots of dogs that have been through it and adjusted wonderfully.  They run and play like there is nothing different.  None of the dogs I know of were 13.5 when they lost their leg.  Arri is young at heart and playful when he isn’t napping.  On the other hand, stopping all treatment reveals a huge amount of guilt, just thinking about it.  Knowing he has a disease that has one more treatment option and not choosing to do it.  Watching the cancer grow and spread.  Seeing him become lame and then sick and in pain once the cancer moves to the organs or bone or lymph system.  As hard as it will be to see him without the leg, I can’t torture him with the disease.

So now I have committed to the surgery.  The next hard decision is who will perform the surgery?  I have an estimate from the cancer center.  But they also said to talk to my own vet.  They don’t want to step on toes and if I am more comfortable with him doing it, he should.  I know my home vet will be less expensive and less time travel.  But it is also a small clinic where amputation is only done once a year or so.  They don’t have overnight staffing which may or may not matter.  I know someone would stay overnight if it was necessary, I just don’t think it is common.  We would just as soon keep it local but my emotional side is taking over.  I don’t want Dr Mike to have this responsibility.  I don’t want him to be the ‘bad guy’.  You know, the parent that disciplines is the mean one.  Since I currently have four other dogs and a cat, he needs to be the good guy in my eyes.  I know he is capable of the surgery and would do a great job.  In a situation where there were no other doctors involved, I would not hesitate.  I don’t question his abilities.  It is an emotional choice. He has been Arri’s doctor for 13 years.  I don’t think it would be an easy surgery for him or his staff to do, unless they are faking how much they like Arri, which I do not believe they are.

I call the cancer center to schedule the surgery.  It brings tears to my eyes to commit to the appointment – May 21, over two weeks away.  The receptionist is very encouraging and that is reassuring.  Since we didn’t really talk details of surgery during the appointment, I ask if the surgeon can call me so I can ask questions.  She suggests I consult with him the day of surgery.  Thank you, NO.  I can’t mull over questions and doubts for the next two weeks.  As soon as I mentally committed to the surgery, I immediately started planning.  Do we need a ramp for the van? What about the step going out of the door, too steep?  How long is recovery?  What kind of pain treatment?  Post surgery care?  Wound care?  Do we need to get a sling?  And on and on.  My brain and stomach hurt, not to mention my heart.  While I didn’t ask her any of the questions, she might have been able to hear my brain swell over the phone.  She says she will ask Dr Walshaw to call that afternoon.   

Dr. Walshaw did call fairly promptly.  That was nice because I don’t need more time to come up with questions  and fret about them.  He initially started into the ‘day of surgery’ routine….drop off, surgery, phone call, overnight, phone call, pickup.  Been there, done that, not what my questions are about.

Question:  What does the surgery entail?  Is the leg removed at the hip?  Answer:  no, that is not necessary in this case.  The femur will be cut in a ‘1/3 something something’ (medical term) procedure.  In other words, a portion of the femur will be left.

Question:  Will there be bandaging?  Answer:  No, for (obvious) reasons.  Bandages will prevent proper toileting.  There will be a need for compresses and cleaning.  I didn’t ask details but that will be covered when we go home.

Question:  Will he have staples or sutures?  Answer:  Neither.  Dissolvable sutures will be used internally.  The outside will be glued – like the ankle surgery.  (me: This I have got to see.  That is going to be a big wound  or maybe not)

Question:  What about post surgery pain care?  Answer:  They intend to insert a catheter into the spinal area for direct pain control during the surgery.  It will stay in for 3 days.   (me:  I did not ask if a return visit is necessary to remove it)

Question:  do I need a special sling?  Answer:  They will provide one.

Arri is to avoid stairs, be kept on a single level of the house.  He will need help going in and out – one step.  Recovery should happen in 2 – 3 weeks.

I felt a lot better after the call.  I am still not thrilled but I know my choices are bad option and worse option.

May 1, 2012 Second Chemo?

By breakfast, I had made up my mind to keep the appointment regardless.  I know the Dr. will not talk over the phone about treatment knowing the tumor has changed but not being able to examine it.  Much to her credit, the tech did call before 9:30.  The surgeon said we should come in even if chemo is not done. The change in tumor needs to be looked at.  They had not seen it in 3 weeks so it was much larger than the last time.  I see it every day so I just know it is larger.  Only looking at the photos I have taken can I see just how large it has gotten in such a short period of time.  (Note to anyone with a pet that has a visible medical issue – take photos regularly.  It makes a world of difference to see any changes in color or size)

We arrived to the appointment on time.  Arri was happy to be in the car and just as happy to arrive at the oncology office.  His lamb toy from months ago had been washed and was waiting for him in the reception area.  The first step was for the tech to take him in back and give him a once over.  I got the impression she was going to do blood work.  This was a different tech than the one that called so I don’t think she had yet realized chemo wasn’t going to happen.  I pointed out the lump in his tush so they could check it.  To the back he went for vitals check etc. 

He returned to a patient room with Dr. Obradovich.  She confirmed the mass she found was the same one I found.  We discussed the growth of the tumor and lack of effectiveness for the chemo.  There are other chemo drugs but the Carboplatin is supposed to be the most effective.  Since it was not effective on Arri, it is very unlikely that another drug would work.  Back to the treatment area he goes to have the two lumps aspirated.  When Arri returns, I learn that both lumps are lipomas – fatty tumors.  Nothing to be concerned about. 

On to the serious discussion.  What is next?  I have 3 options. 

One;  stop treatments and let the cancer grow unchecked.  At some point the cancer will affect a major body system and he will die. 

Two: try metronomic chemotherapy.  This one has come up before.  It is a daily at home pill, low dose chemo.  I think this might be the first time I learned or it sank in, how it is different from regular chemo.  Regular chemo attacked the cancer itself.  If I understand correctly, metronomic attacks the blood supply to the tumors.  How it does not attack the blood supply in the whole body is a mystery to me.  The same way aspirin knows to take care of the pain in your back and midol is for cramps.  Just how does the medicine know to go where it is supposed to?

 Three:  amputation.  This is the best and final treatment option at this point.  Even though it has been floating around in the back of my head for 4 months, it now has to be seriously considered.  All other methods have been ineffective.  All Drs and techs involved think Arri would adjust just fine.  It will be much harder on me than on him.  Dr Obradovich would do hip x-rays before continuing forward to ensure Arri could tolerate being a tripod.  I authorize the x-rays to be done right then.  Might as well get it over with.   While I am pretty sure his hips are fine, no point in struggling over a decision that becomes a non-option if his hips are bad.

When the tech brings Arri back from x-rays, she tells me they weren’t quite sure how that (getting x-rays)  was going to go.  They are well aware that Arri is a dork.  They needed to put him up on the table and have him lay still on his back.  They didn’t sedate him at all.  If I had known that ahead of time, I would have wished them luck.  Arri doesn’t mind being on his back and getting a belly rub but up on a table is different from a soft, comfy sofa, the floor or a bed.  They were very pleased when they got him in position, he just relaxed and stayed in place.  Both Dr Obradovich and Dr Walshaw (surgeon) reviewed the x-rays and declared him good to go.  Now, I just have to decide what to do. 

We leave the appointment with an estimate for surgery costs and two weeks worth of metronomic chemotherapy drugs and anti-inflammatory.  Arri still has to have a good blood test before he can start the chemo but I will have them when I need them.  If we don’t use them, I can return them and be refunded for the cost.  Tim was not at the appointment so deciding about surgery has to wait.  On the drive home, I call Dr Mike to make an appointment for a blood test next week.