Something is happening with Maddie and we aren’t sure what it is, but it sure is freaking us out. A few days ago we felt like she was showing a bit of resistance to walking and was faster than usual to sit or lie down. No signs of discomfort, pain, whining, teeth chattering, welts, lumps, etc. We assumed she tweaked something so decided to reduce her activity to give her a break and we would keep an eye on it. We also recognized we might be hyper sensitive and so noticing something that wasn’t actually anything. But Maddie is a pretty lazy dog so no harm in letting her be her couch potato self for a few days.

Unfortunately things have not improved and only worsened.  She became more unstable on her feet, going down stairs, in particular. Then she actually tripped going down the short stairs to our yard. Then we noticed instability on her feet basically all the time. So we decided it was time to call it in.

We called her oncologist last night. They recommended radiographs to see what is going on (mentioned arthritis, soft tissue injury, etc. as common potential issues), and that we start with her regular vet for those. The earliest appointment her vet has is Monday.

Well this morning I heard Maddie get up. Shortly after I heard a big thud and she started whining. She was laying down where she fell and was now chattering her teeth. Jeremy took her outside and had to carry her down the stairs. She was able to do her business, albeit wobbly, but then wouldn’t let Jeremy pick her up to bring her back in. She hasn’t settled and is clearly very uncomfortable. It’s really upsetting to see.This has changed so quickly. Really concerned about what could be going on and what actual options we will have for her to feel okay.

We called the vet and there is no way they can get her in today, so we are about to head off to the emergency vet. Thankfully the place Maddie does oncology has an emergency department, so at least they’ll have all her records already.

The last time she had a limp and we took her to have it looked at, they told us she had cancer and amputated her leg. Loathe to think what news we have awaiting us now.

I'm sorry to say we don't have great news. Actually, we have sad, bad news.

After the neuro consultation, the ER vet theorized either a cancer spread, disc injury/disease, or a stoke-like event in the spinal cord. To get a clearer diagnosis and assess a surgical plan, they suggested doing advanced imaging, including an MRI, an ultrasound, radiographs, blood work, etc. To do that, they wanted to keep her overnight. Jeremy and I tried to ask all the questions we could. When we asked about potential next steps with each of the various diagnoses, the options were all really either invasive spine/back surgery or extreme crate rest for 4-6 weeks to see if there is any improvement. Recovery and rehab for the potential surgeries would be slower and harder than her amputation. Also, she now has minimal to no mobility in the back and only one front leg, which when considered with her age (almost 9) and weight (almost 100lbs) would make recovery and care extremely challenging for her and us. Difficult for us we can handle, but miserable for her we cannot.

Throughout her cancer journey, we have tried to make our decisions for her care with a lens of prioritizing her quality of life -- extending her life as much as possible, so long as she will have opportunities to enjoy that life. Given that, we were not prepared to make her go through that back/spine surgery and recovery process. This left crate rest as the most likely potential next step, regardless of diagnostic result.

We elected to do just radiographs and then reassess. At that point our thought was we would do the X-rays and then bring her home, keep her comfortable, let her rest up as much as possible, and hope for any improvement in her condition. While radiographs may not give us all the potential information, we figured we could decide after whether we wanted to pursue other diagnostics. We didn't want to miss time with her or put her through medical trauma for next steps we weren't planning to take.

A couple hours later they called to discuss the initial results from the X-rays. Preliminary results show not one, but two different concerns. The ER vet saw a "whiter" questionable area on a vertebra that could be consistent with osteosarcoma spread. They also saw a possible pulmonary nodule. When they compared the X-rays to Maddie's December scans, it looked like a definite change. Because we didn't do the more extensive imaging, other diagnoses are not necessarily ruled out. The ER vet also made very clear that she is not an oncologist and that the scans were still awaiting radiologist review which usually happens in a day or two.

We decided to proceed with the plan of bringing Maddie home and having her rest through the weekend. We would then consult with oncology on Monday (they aren't there on the weekend) to discuss the results and options for next steps, and go from there. Thankfully she hasn't shown any real signs of pain (the ER vet noted that Maddie also didn't seem to be in any pain during the exams), but we are giving her gabapentin to help make sure she is as comfortable as possible. 

When we picked her up from the ER vet last night, she was unable to stand on her own without support and use of a sling, but she seemed to be able to put some weight on her back legs with support. When we got out of the car at home, she even tried to go bunny hunting in the front yard -- we just wanted her to pee, but she tried to go hopping/hunting while Jeremy was supporting her back end. Unfortunately a few hours later, we saw further marked deterioration. She was unable to put any weight on her back legs and had no control of their movement, with super stiffness in her back legs. She also seemed very uncomfortable and anxious about our efforts to help her move. All we wanted is for her to pee! It became very difficult to even get her back end up, even using the sling. By the time we went to bed, we were not feeling good about waiting until after Monday to make a plan unless we saw today some signs of stability in her condition. To be clear, we didn't expect an overnight miraculous recovery, just a limit to further deterioration.

This morning was rough. Back end stuff seemed at least as bad as last night, and we suspect worse. More critically, her discomfort and anxiety with her state of being were clearly worse. Intellectually she is all there, but physically not at all, and that is severely impacting her mental happiness. If she tries to do something normal and cannot (such as move to get water/food, sit up when we walk in, get up to greet someone, etc.), we see lots of anxiety from her at not being able to. We see lots of signs of anxiety when we try to have her move or help her move. Still no signs of pain -- thank goodness. When she is lying down, she appears very comfortable and resting well, but she isn't doing anything other than just lying there unless we are trying to make her, and when we move her she is miserable. Yesterday, she would try to get up for things. Today she isn't even trying. This is not a quality of life for her that is fair to her.

This morning we decided to set up an in-home euthanasia appointment for tomorrow and that waiting for Monday to talk to oncology was not likely to be best for Maddie. If things seemed to improve/stablize throughout the day, we could always cancel it and make a new plan. In the meantime, we invited over Maddie's two favorite people to give her allllll the treats, snuggles, and ear scritches. One came earlier today, and it was so sweet to see Maddie smile at them (although it also came with anxiety that she couldn't get up to say hi as she wanted). Her other favorite person is coming tonight.

Sadly we haven't seen anything yet that makes us want to change our course, unless something dramatic changes between now and tomorrow. To say we are devastated is putting it lightly. This has happened so quickly and we weren't ready for it. Five days ago, she was living a full happy tripawd life. Five days later she has no mobility at all in her back legs and no ability to hold her weight up. We are so sad, disappointed, and heartbroken to get the dreaded news that her cancer is still there. That being said, we were both surprised to also acknowledge a small amount of relief that this seems to be her cancer rearing its ugly head, as opposed to a new thing. It seems extra unfair for her to have another problem on top of cancer. Also, we've been preparing ourselves for the possibility that cancer would take her life for six months. Doesn't make it easier or better.

We think it important to say that we do not for one second regret our decision to amputate her leg. Over the last six months, she has had a great quality of life. She recovered so quickly from her surgery and became a very happy and capable dog on three legs. She gave up her bonus leg and has had a wonderful extra bonus six months of life.

But now it is her time to cross rainbow bridge. I'm sure Barley is already there waiting for her, where they can run together and never get tired.

Barley and Maddie the first night they met each other.