Caring for a Three Legged Dog or Cat
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Hi everyone -
Big thanks to Rene and Jim for keeping up on my personal blog posts and being so supportive! I received some sad news about Smokey last week and I'm just devastated. My baby boy has a large mass in his abdomen and it doesn't look good. Long story short, the way I see it is that he has a ticking time bomb in his tummy that can rupture, leak, bleed out at any moment and then he'll slip away. I'm in the denial stage right now, I must admit. I'm trying to find a way to live with this news but it's really hard to try to live in the moment, knowing that anything can happen at any time. I knew this was inevitable, but I really, really, really wish that our furry best friends can live forever. Or at least longer! But I know how fortunate I've been with Smokey, being as tough as he is. 13 1/2 years old, just celebrated the 25th month ampuversary yesterday, but now this. I swear I'm falling in love with him again and again every time I see him. And it's so hard to leave him right now because I don't know when something can happen. I'm so lucky that my company is flexible though and allowing me to change my schedule a bit so I can be at home with him for most of the time. Or as much as possible.
Instead of trying to explain it, I thought I would share the email that I received from our vet, who I still strongly believe is the absolute best vet ever. The ONLY good thing is that she has assured me that Smokey will not be in any pain. That is the only thing that is really keeping me going right now while I try to find a way to accept this.
Here's the email I received after our vet visit that describes what is going on. Curious, have any of you experienced this type of situation in the past?
Smokey has a mass in his abdomen, and I suspect this is the reason for the swelling in his hind legs. He seems comfortable and he is eating well. He does not have a fever. His chest X-rays were negative for apparent spread of the mass, but as you know, he would have to have relatively large masses in his chest before they would be visible on the X-rays, so we cannot be absolutely sure the mass has not spread. At this point, we do not know what tissue(s) are involved in the mass, but I suspect it originates from the spleen. We also do not know whether it is cancer or a benign mass. Whether it is malignant or benign, you should be aware that it is possible for the mass to bleed, either slowly or as more of an emergency situation. The capsule of the spleen does not stretch well, so after the mass reaches a certain size, bleeding is likely.
Options (in order of "aggressiveness"):
1. Exploratory surgery. This would allow us to remove the mass, and the removal of the mass would mean that we would minimize the risk of spontaneous hemorrhage at home (as the tumor would be removed). Surgery would also allow us to examine the rest of his abdomen for evidence of tumor spread. We would send a piece of the mass to the lab for analysis, and this would tell us if the mass is cancer or not. If it is not cancer, he would be "cured." If it is cancer, his prognosis would still be poor. We would eliminate the risk of hemorrhage from the tumor/spleen, but most dogs with the type of cancer that usually affects the spleen live for only a few months after the spleen/primary tumor are removed. (The mass tends to spread to the liver before it is discovered, so it has usually already spread at the time of surgery.)
Pros: Definitive diagnosis. The chance for "cure" if it is benign.
Cons: Recovery time. The fact that it does not buy him much time if the mass is
cancer.
2. Additional diagnostics. Another option is to have an ultrasound performed before making a decision regarding surgery. (Or to obtain more info. in general.) This would allow us to evaluate the mass, decide whether it is attached to the spleen +/- other organs, and evaluate the liver for evidence of spread of the tumor. If the liver is involved, the mass is most likely cancer, as benign masses do not generally affect multiple organs (therefore we would not consider surgery.). An ultrasound would also allow us to obtain a biopsy of the mass (this would be optional), but you should know that a biopsy of such a small sample is not always as helpful as we would like it to be–sometimes the
pathologist needs more cells than the biopsy instrument can safely collect. It is also possible that the biopsy procedure could result in bleeding from the mass.
Pros: The possibility of obtaining a diagnosis. The ability to obtain more info re: possible spread to other organs before making a decision about surgery.
Cons: The biopsy may not be diagnostic. The possibility of causing bleeding from the mass.
3. Do nothing. You may decide not to pursue any diagnostics or treatment. Smokey seems comfortable and happy, and it is reasonable to decide that he should not undergo any more testing/treatment/surgery, especially given his amputee status and arthritis. You should know that there is a chance that the mass could begin to bleed, either slowly over time or as a more acute hemorrhage. This could mean that you may have to make decisions in a crisis situation, and we have no way of knowing when or if he will bleed. I am concerned about the possibility that you might find him in a hemorrhagic crisis and be unable to transport him to the clinic. The mass is not painful, but this type of hemorrhagic situation may be stressful for Smokey (and you!), and I would like to prevent this if possible. I would like to gently suggest that you think about whether you would consider euthanizing him before he has to endure a hemorrhagic crisis. I would like to do everything I can to provide both of you with the least stress, and a "planned" euthanasia may be something to think about. I know this is hard to think about, but I really do need to bring it up.
Remember to avoid pressure on his abdomen. You should loosen the abdominal strap on the harness and use the other support strap that you have–place it as far back on his belly as you can. I will call tomorrow with the CBC result. Please feel free to call or email anytime if you have questions–I expect you to have many after you have had time to process. I work Monday through Thursday in September.
I am so sorry you and Smokey are going through this. He is such a wonderful dog-one of my favorites. 🙂
Give him a hug and a cookie from me.
Stephanie Harvey, DVM
I have no words of wisdom or experience with what you are going thru. Only know that I am thinking of you and Smokey... Big hugs from Maggie and I here in Maine...
XOXO
Tracy & Maggie
Maggie was amputated for soft tissue sarcoma 10-20-09
Maggie lost her battle with kidney disease on 8-24-13
We went through the same thing with Skyler. They did a biopsy and determined that cancer had spread to her spleen. We decided to go ahead and plan a euthanasia (as she wasn't easting or doing anything). At that point, she had no quality of life. Since it's all about quality of life, we knew it was time to let her go, even though her amputation was only 3 months earlier. We didn't want to come home to a crisis from a bleed-out, especially since we also have her sister Chloe at home. Whatever you decide to do, we support you. Listen to your gut - you'll know in your heart what to do. If his quality of life is still good, you may opt to do 1 or 2. Please keep us all posted. We're sending you pawsitive thoughts and prayers!
Cathy/Jane/Spirit Skyler/Chloe
It's so good to see you here. Smokey is one of the longest-surviving Tripawds here and a real beacon of hope. His journey has been amazing, and miraculous to say the least. We hope that he has many more beautiful adventures with you, and send lots of pawsitive energy.
Two Tripawds I am thinking of that have been through a similar situation were Tshuvah and Captain Jack, both of whom recently earned their wings. I know their Moms would generously offer you their perspective. I will PM them and let them know about Smokey.
Today, I offer this perspective courtesy of Guardians of Being. I hope it helps in some way.
with some dogs you just look at them –
just a little look is enough — and their tail goes . . .
"Life is good! Life is good!"
And they are not telling themselves a story of why life is good.
It's a direct realization.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
All I have to say is take a look at this forum post originally posted by Golden Girls in a previous forum "Is it the end". Just some things to consider. (I cut/pasted the most relevant parts, in all it is pretty long)
Defining "Quality of Life"
by Moira Anderson Allen, M.Ed.
Whenever one considers the painful choice of euthanasia, one is always advised to take the pet's "quality of life" into account. But what is "quality of life"? How can you determine whether a pet is still experiencing a good quality of life — or whether its level of suffering is no longer acceptable? That decision is individual to every pet, and every owner. Following, however, are some factors to consider when attempting to assess a pet's quality of life:…
Discomfort:
It can be difficult to determine whether a pet is in pain, as animals instinctively mask discomfort as much as possible. You can pick up clues, however, by watching its posture and expression. Does your pet's face appear furrowed or "worried", rather than relaxed and happy? Does it sit hunched or "hunkered" and tense, rather than relaxing and lying down? Lack of mobility can also be a sign of pain.
Another indication of pain is "denning." An animal in pain will seek a safe place where it won't be disturbed by other animals. If your pet has forsaken its usual territories or sleeping places for the back of the closet or a spot under the bed, this may be a sign that it is pain or distress and feels vulnerable.
A more obvious indication of pain is a pet's reaction to touch. If your pet responds to touch by flinching away, hissing, snarling, or even snapping, this is a clear indication of pain. Sometimes this can indicate a localized pain; if the pet doesn't want to be touched at all, however, it may indicate a broader discomfort…
Making a Decision:
Assessing a pet's quality of life is an ongoing process, not a one-time decision. Initially, we're likely to attempt to compensate for the problems we see. Pain medication may relieve a pet's discomfort and improve its mobility. A change in diet may improve a pet's appetite or provide better nutrition. We may resolve that we're willing to clean up after a pet and carry it wherever it needs to go, for as long as necessary. But eventually such measures will cease to be effective. The process of assessing "quality of life" is really a question of determining (and deciding) when that point has been reached — and what you intend to do next.
It is often tempting, at this point, to postpone a decision still longer by deciding to "let nature take its course." Before choosing that course of action (or inaction), however, it's important to understand that, as a pet owner, you have been thwarting the "course of nature" from the beginning. By ensuring that your pet has food and shelter and is protected from predators, you have already guaranteed that nature will not take its course. By providing medical treatment, you have prolonged the life of your pet far beyond what it could have expected if left to "nature." In nature, an animal that becomes too ill to obtain food or protect itself will perish quickly, though not necessarily comfortably.
Nor does nature necessarily offer an "easy" death even if you choose to let it "take its course" in the comfort of your home. An animal that cannot breathe easily, cannot eat or digest food properly, cannot control its bodily functions, and can scarcely move or enjoy human contact because of pain, is hardly dying "comfortably."
This is really what the "quality of life" issue is all about. By usurping nature's role throughout the life of our pets, we must sometimes also accept its role in determining (and bringing about) the death of a pet. To accept this, we may also have to accept that, in some cases, the quality of life we're really trying to protect is our own: That we're allowing our pet to suffer out of a desire to avoid the anguish we know that we will experience when it dies. And that, ultimately, is the most unselfish act of love we can offer: To end a pet's suffering, we must choose to accept our own.
-Chloe's mom
Chloe became a rear amp tripawd on 7-29-10. Another tumor was removed on front leg 2-20-14. Found 3rd tumor on neck 2-2015, but she's still kicking cancer's butt at age 14. Chloe's blog
I don't know what to say...25 months is just an awesome number, especially to one who had only 3....know that we support your decisions, come often for strength and you have an amazing vet, just amazing.
and Chloe's Mom...that is a terrific excerpt...it really puts it out there and maybe we should all always keep that in mind as we get to "that horrible time" when those decisions have to be made.
hugs...
Sorry to hear about the mass! It's really like getting the diagnosis all over again...you think everything is going OK, then BAM! I found a mass in Jack's abdomen around his 13 month ampuversary. I called the vet in tears saying I needed to have him put to sleep blah blee blah blah blah and she was like, hold on a minute...he just has a mass. He's still FINE. She was right...other than a new mass, he was the same old dog (well, not really old as he was only 6...). Here's what we went through after that: he had a urinalysis and high levels of bilirubin were found indicating a problem with the liver (meaning it has most likely spread there). He was put on an antibiotic for a couple weeks then started prednisolone. The only thing that really happened was ascites (his abdomen became filled with serous fluid). I had his abdomen tapped once ($93; they took out about 900mL of fluid; took about 20 minutes). This gave him a few more days of comfort. Yes, I was paranoid about things rupturing and such, but mostly I just paid attention to what Jack was "telling" me. He became uncomfortable only because of the fluid build-up...nothing else was wrong really. He stopped jumping up on things, he had difficulty walking (I'd have trouble too if my entire abdomen was swollen...yuck!), but up until the day he died, he would still chase his precious pink ball...a little slower with a rest in the middle, but he never once gave up. I had decided a while ago that I wasn't going to do anymore treatment options other than supportive care, but it was still really hard to not "do" anything. I had to tell myself it wasn't about me, it was about my doggers and I had to do right by him. It sounds really silly, but I would have conversations with him, to let him know I would keep him comfy and then when he was ready, he could tell me (don't say it in your head, say it outloud). Every day I would tell him how much fun I had, how much I loved his little paws, his squishy neck, his snuggles. This was my way of giving up control. I also planned out exactly how I wanted "the end" to happen. I didn't want to make an appointment (as soon as I knew I would take him into the emergency/specialty center), I wanted to be in the room, I wanted to be laying right next to him, and I wanted to close my eyes when he did so the last thing he saw was my face and the last thing he heard was "I love you". Everything happened exactly according to plan. Seriously, I had every little detail planned out - this way it felt more like the next step rather than a catastrophic event and my dog was dying. We are at an advantage that we KNOW whats coming, we may not like it, but we have the power to make it a positive experience rather than a horrible one. The time we have left with our babies should be spent experiencing the world together, not feeling sorry for ourselves because we can't cure cancer. Jack lived a full life for almost another 2 months after the mass was found. I miss him, but I'm not sorry, because every memory I have is positive. We are blessed to be given these animals, to be allowed to learn the lessons they teach us. I felt it would be a disservice to Jack to be upset, because he never once was. It really does suck, but you can handle it...you can't control cancer, but you can control how you react to it. Learn everything you can, enjoy the weeks, months, or years you have left, and someday you can share your experience with someone else and let them know that everything will be OK.
<3 Laura and Invisible Jackers
Thank you Laura, very well said.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Yes, thank you so much Laura. That was so well put and sounds exactly (or at least very close to!) what we're going through. And Jerry/Rene/Jim, thank you for this - it was really good to read:
"You just watch the tail…
with some dogs you just look at them –
just a little look is enough — and their tail goes . . .
"Life is good! Life is good!"
And they are not telling themselves a story of why life is good
The toughest part is he's fine otherwise...completely happy, hyper, otherwise doing well. And he's always been a trooper! I've had many a conversations with him about me telling him he needs to let me know when he's ready, etc. I have never been so spiritually close to a dog like I am with Smokey. Our family has always had dogs, they are our family, but with Smokey, he's the first that he's all mine and I just really truly hope that he knows how much I love him. I do think we have conversations with each other and we can read each other's minds 😉
I am still eternally grateful for this forum to be able to share experiences and learn from others.
I am so sorry to hear about Smokey. It really is sensational that you got to make so many memories in these 25 months.
Wishing you all the pawsitive thoughts possible.
Comet - 1999 to 2011
She departed us unexpectedly January 23, 2011 at the age of 12 1/2.
She was born with a deformed front leg and a tripawd all of her life.
I'm sorry you have come to this point with Smokey. I came to a similar place with my Tri-pug Maggie last March. The details are a bit different, but I was left to make decisions on whether or not to pursue aggressive treatments.
Maggie was a long term survivor- she actually made 3 years and 9 months after her amputation for mast cell cancer. Her prognosis was 6 to 9 months after the amp because the cancer appeared to be in the lymph system. During that run we did have several cancerous skin tumors removed. I decided when she turned 10 (in 2009) that I would not put her through any additional surgeries or do any more aggressive treatments.
Last March she was diagnosed with a malignant melanoma tumor in her mouth. I talked to the oncologist about options, the only way to have a chance at beating it was to surgically remove the tumor, including part of the jaw, and then do radiation treatments. At this point Mag was almost 11, and had also developed some other health problems.
I will admit that it was tempting to do 'everything' and try and beat it. After all she seemed to have beaten the first cancer, in fact I had just started to think that I wouldn't lose her to cancer. Then I though about why I had decided a year earlier not to do any more aggressive treatments- it was all about her quality. We could have run more tests- but the outcome of the tests would not have changed my mind.
What really helped me was to have clear in my mind what quality of life was for Maggie, and to decide what conditions were not tolerable. I did think once in awhile during her last three months 'what if I treated it..'. But I just had to look at Mag to see that I had made the best decision for her. While sometimes challenging, those last three months were some of the most rewarding in our 11 years together.
And as far as having the strength to make decisions for Smokey- this is something I posted here just after Maggie passed:
We all have made gut wrenching decisions throughout this cancer
battle. We decided on amputation, we decided on treatment, and we
decided when it was time to stop treatment. We never could have
imagined that we would have to make these choices, but when faced with
it we found the strength.
If you reflect back on the cancer fight so far you will see how much
strength you have gained. In some ways the cancer journey itself has
prepared us for the day when we come to the end of the road.
We have done the best we could, we have made all the hard choices.
Everything we have done, all the decisions we have made, were made with
love and only the best interest of our tripawds in our hearts. And
because we made our decisions this way we cannot be wrong.
Making these kinds of decisions is not easy. Let Smokey guide you.
Karen
My wish is for you and Smokey to have many more days and months to continue to make wonderful memories. I know this must be a devastating blow for you and I hope you find strength and comfort here. You guys will be in my thoughts.
Shanna & Spirit Trouble ~ Trouble gained her wings 3/16/2011, a 27 1/2 month cancer survivor, tail wagging. RIP sweetheart, you are my heart and soul. Run free at Rainbow Bridge.
The November Five - Spirits Max, Cherry, Tika, Trouble & Nova. 11/2008 - 3/2013 An era ends as Queen Nova crossed the Bridge.
25 Months that is fantastic!! Wow you must have had some very special times for these two years. Treasure those memories.
I understand your connection with Smokey, I felt the exact same way with my beautiful girl JD, so connected and in such a unique and special way.
Your Vet has clearly explained the options as she sees them and you have a bit of time now to consider them all. I will echo the idea of having a plan, it may be that you implement it hopefully later rather than sooner, but have one. I had made a Quality of Life list for JD, the things I would NOT go beyond if she showed me the signs. Unfortunately an accident came upon her just as we were beginning treatments and starting her fight against the cancer. I had to make a decision for her euthanesia, in a matter of minutes. Having thought through the Quality of Life list earlier I was able to see, through my shock and horror at the horrible injustice of her accident, and make the decision I knew in my heart was right.
I say all this just to ask you to enjoy this time with Smokey, we never know when their time will come, and it may not be related to cancer at all.
Sending you warm wishes and 25 pats for 
Smokey to celebrate his special ampuversary.
Spirit JD's mom
JD
One Tough Girl
(1999-2010)
-Diagnosed with osteosarcoma of her left front leg –
-Amputation July 23 2010 –
-The cancer didn't get her, but she is gone-
-She fought the cancer and loved life till bloat brought her down August 29th, 2010-
Now she watches over her mom and two new sisters, the Quad-Paws Serena and Maya
Thanks Jim and Rene for alerting me to this post. I'm trying to think of what to say, what to offer. I lost Tshuvah just last week to hemangiosarcoma, which must be what your vet is considering as the diagnosis if the mass is cancerous. Tshuvah's course of hemangio was a bit unusual in that her primary tumor was in the bone (thus her status as a tripawd starting June 10th) and she didn't display any signs of abdominal masses at the time of amputation nor three weeks later when the diagnosis of hemangio (vs the suspected osteo) was made. She lived well and happily for three months during which time we did no testing or interventions of any sort other than pain meds. That's another way in which her hemangio seemed to have been different than the average. We were also told that hemangio does not cause pain and that the end would be sudden, however toward the end of her life she did display signs of increasing pain and had difficulty walking. She was breaking out in skin lumps (on the skin and just under), and in that last week we saw a noticeable swelling on one of her hind legs (she was a front amp). So my guess is that she was developing another bone tumor which was painful and made mobility nearly impossible. So we did plan euthanasia for her...although we ended up doing it three days sooner than the original plan because of her pain.
Living with what is basically an imminent death sentence is heartbreaking and stressful, no matter how one spins it. I feel we did well, living each day of our three last months together "with no regrets". She ate as much ice cream as she wanted, and as much elk, venison, duck and buffalo jerky as she could. We went on long forays to the park most days. I fully expected that I would wake up to her lifeless body one of those mornings, or come home to the same after a day at work. That never happened for us, but I certainly remember that reality.
If I was in your shoes I would probably go for the ultrasound since it is non-invasive and might give you more information from which to make your plan for the time you have left. That's what we did; at the time of diagnosis of hemangio she had a very thorough abdominal ultrasound to know the extent of the spread of the cancer (at that time there was no spread); this gave some predictive ability as to her life expectancy and it helped us decide to take Tshuvah with us on our summer sojourn to Chicago. But you will know what is best and right for you and Smokey; as everyone has said, there is no wrong decision when you decide with your heart, with your love, and with whatever information you feel you need.
Feel free to PM me as there are so few hemangio dogs on tripawds, and I will watch for future posts. My prayers are with you and Smokey,
Beth
Beth with my beloved Tshuvah, 10 year old "TaosDog". Provisional diagnosis osteosarcoma on 6/10/10, amputation of left foreleg same day, firm diagnosis of hemangiosarcoma 6/24/10. Set free on 9/9/10. Treasured forever.
http://labrador.....ipawds.com
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