I have had my Great Dane, Oakley, since he was 7mos old. I picked him up from a rescue group only knowing his age and was surprised to see he was already 92lbs! Since then, he has been through everything with me. He is my whole world. My bedbuddy. My love. Until last month, he was as healthy as a horse. Perfect hips. Bloodwork and urinalysis came back clean last month (annual testing). 

I am extremely fortunate to work for a college of veterinary medicine, with access to the teaching hospital. My boss is one of the best orthopedic surgeons of all time. I am his clinical research technician in charge of his gait lab and clinical trials. My only other direct colleague is a board certified veterinary anesthesiologist. My resources are phenomenal.

Three weeks ago, Oakley went outside in the rain and got muddy feet. When he came inside, I grabbed his foot to wipe it off, and he snapped at me. He has never done this before and WOULD NEVER bite me, so he climbed into my lap out of guilt. I looked down and noticed his hock (ankle) was swollen. I sent a pic to the anesthesiologist. Lets call her Dr. K. 

Dr. K called me immediately and said it looked like osteosarcoma. I should bring him in to work and have Dr. B (the orthopedic surgeon) look at him. We would need xrays (radiographs) to check it out. Fine. Cancer. I can deal with that. No big deal. We'll do what we have to do. So I started to research. And I convinced myself it was osteosarcoma. Ok, we will take off the leg. We got this. 

This took place on a Saturday. On Monday I was very busy at work and needed to talk to Dr. B and radiology about getting Oakley in. This is where my luck starts to kick in. I speak with radiology at the teaching hospital and tell them I need tarsus rads, and I ask if they could possibly use Oakley in their teaching lab. This would mean I get the rads for free, in exchange for them using him as a teaching tool. They agreed to do it. Dr. B looks and says this is a really weird place for osteosarc. Distal tibia. He wasn't convinced and wanted to wait on rads. Rad lab needed me to come in on Friday. 

It was only a few days but it felt like forever. Friday, Oakley went in for rads. Chest (3 view) and tarsus rads, for free. On a large dog, so multiple views. I just saved about $400. 

You can see in the rads that there is soft tissue swelling around the bone. This isn't a tumor or a cyst. Also, you see peritoneum outside the normal outline of the bone. Signs of osteosarc. Dr. B was still not 100% sure, but the radiologist and oncologist both confirmed diagnosis. 

As we showed the rads to oncology, someone mentioned that there was an osteosarcoma study going on. A clinical trial. It offered free chemo. What?

I inquired with the oncologist and was told the project was put on hold 🙁 She said she would e-mail and "check up on it". Dang it, I just missed it. Ok, so. Osteosarcoma. Amputation. Median Survival Time (MST) of 4mos. With chemo, 10-11mos. 

This has been an insane three weeks. I literally paid nothing for diagnosis. And I knew I could get a break on the surgery. But chemo? I looked in the medical records at another Great Dane that received chemo, and his total bill after surgery and chemo was nearly $8,000. 

Listen, I love this dog. He is my whole life. But he is 9 years old. Call me morbid, but he was dying before he even got cancer. People suggested I set up a GoFundMe. No. I'm not an impractical person; if this made sense to me, I would find my own way to pay for it. But I don't know. Just make him comfortable for 4mos? They said the cancer would progress and metastases would form in his lungs. This would be his cause of death. He would be euthanized after labored breathing and inappetance. But he wouldn't feel any pain. 
This, I could handle. I thought, "It doesn't matter about me and my loss. As long as he's comfortable." I started to accept that he was going to decline, rapidly, and taking the leg was the best way to make him comfortable during this process. I don't think it really set in yet; I was thinking about things so scientifically. 

I told Dr. B's surgery tech that I would be in next week for the amputation and to get me in on the schedule somehow, please. Oakley and I went home to spend the weekend together. 

On Monday, I nudged at the surgery tech. Wednesday and Friday are cutting days, and I wanted in on Wednesday. She wrote me in. 

On Tuesday, as I was preparing to bring Oakley in the next day for his amputation, I was intercepted by the oncology technician with good news: the STUDY WAS BACK OPEN. Ok, I had already convinced myself I wasn't going to do this to him. Make him come back and get poked at. Or maybe I was just trying to justify the fact that I couldn't afford it. I don't know. But when I thought 4mos vs 11mos...I had to look into this study.

The study measured the control group, which was "standard of care" (amputation plus carboplatin chemotherapy), to "standard of care" followed by the test drug (rapamycin) group. Both groups would receive $1,000 towards the cost of amputation plus 4 free sessions of chemotherapy afterwards, including bloodwork and follow-up care. Uh, hello. Sign me up!! 

I was so grateful they caught me on Tuesday, the day before Oakley's surgery, because to get into the study, a few more things were required, such as bloodwork and a clear ultrasound. I had no intention of doing those things before the surgery, and had I proceeded with the surgery before doing these things, I would not have been eligible for the study. Shit, an ultrasound? That's about $200. My luck just keeps getting better though. The oncologist personally walked over to radiology and asked a favor of the doctor. He agreed to see me the next morning, for free, to offer a report of clearance for the study!!!

Wednesday morning at 10am, we had our abdominal ultrasound. Two nodules were present on Oakley's spleen, and we performed a needle aspiration on both to send to clinical pathology. This is pretty common in old dogs, so we weren't really concerned. We still got the clearance on the lungs (no mets!) and were all set to enter the study. Before the surgery, oncology came and collected blood. We were told to call them to come get the leg within 5 minutes of removal. We would need to send off the leg to histopathology to confirm osteosarcoma, of course. 

I sat in on the surgery. Dr. K, the smartest anestesiologist ever, monitored Oakley for me. My boss, Dr. B, removed the leg. I called oncology to come pick it up. Anesthesia induction, maintenance, surgery, and 

He was in the very best hands. After recovery, Oakley was moved to IMC (intermediate care) for the night. I layed with him in his cage from ~3pm until 6. Two hours after surgery, I decided to take him outside to go potty. We used a cart to roll him out, but when he got outside, HE TOOK SEVERAL STEPS. Already. Only 2 hours postop!

I could have stayed the night with him in his kennel, but I felt like a helicopter mom. I don't know any of the night time IMC techs and they don't know me. Plus, I thought it was just most practical for me to go home for the night. I was trying to be reasonable. So at 6:30 I made sure the techs were going to give him more hydromorphone. They left themselves a postit note on his chart that read "6:45 hydro". And then I went home.

The next morning I rushed into work at 7am. I saw, at the end of the long hallway, two students trying to get Oakley outside to the potty yard. They were struggling. They were using a sling to lift him, but he wouldn't walk on his own. They didn't see me. I ran to them outside where Oakley was laying on the ground. He heard my voice and immediately hopped up and walked towards me! With my encouragement, he was able to walk to the ortho wards, assisted. We wanted him out of IMC (it's expensive) to keep a better eye on him ourselves. I brought my laptop to work with me and layed in his kennel with him all day. At this time I looked through his chart, and saw that they didn't give him his hydromorphone until almost 8pm the night before!! I regretted leaving him. He was probably in pain and needed me to advocate for him. Ugh!

He hadn't gone potty outside yet. In fact, in IMC, he started to pee in his kennel and he scared himself. He tried to escape from it. I don't think he could figure it out yet outside, but in ortho wards he was being kind of restless. Like he kept trying to get up and move. So I took him outside. We made it out pretty easily. We layed in the grass together and took a long break. He didn't go potty. We walked back inside. His feet were slipping on the hospital floor, so we had to get a towel and hoist him back to his run. He was still antsy, so we gave him Trazadone, a sedative. He was also smacked with a couple Fentayl patches, whick could be removed in a few days. I tell you, before the Trazadone, he was moving around too much. But after the Trazadone kicked in, he really worried me! He wouldn't get up. He wouldn't walk on his own. And I knew it was the sedatives, but I started to wonder how on earth I was going to take this dog home and care for him on my own. I couldn't even imagine how I would get him up into my Jeep to get him home, let alone get him out when we got there. Dr. B assured me this was not part of the normal recovery process and that I wouldn't have to deal with it after the sedatives wore off. I started to panic a bit about what I had gotten myself into. 

Getting Oakley into the Jeep was a lot easier than I expected. I had a friend meet me at the house to help me get him out. I had brought a queen mattress downstairs to lay on the floor during Oakley's recovery. This was on Thursday evening. Oakley was panting at home. I knew he wasn't comfortable. I knew he had to go potty. He hadn't gone since right after the surgery on Wednesday, in his IMC run. I kept having to help him out of the bed and outside. But he wouldn't go. I didn't sleep much that night, walking him in and out and making attempts at going potty. 

Friday morning I went to work. People asked why I left him. When Oakley had 4 legs, he layed on the bed all day. With 3, I anticipated he would do the exact same thing, even without me there. I rushed home around 3pm to check on him and spend the evening with him. He still would not go potty. I started to worry. He was anxious and panting and I knew he had to go. He just couldn't figure it out. He was starting to dribble in bed. Around 7pm I tried to manually express his bladder. With the missing leg and swelling, I couldn't even FIND his bladder. Then I realized, the damn dog isn't paralyzed, when he has to go, he will go. He's not going to just let his bladder rupture. And just after all this, he went. Outside. He figured it out. And then...around 10pm, he pooped outside! I couldn't believe it. I was so relieved. 

The incision site looked great, but the bruising was extreme. We used an ice pack as often as possible.

Come Monday, we get online and check the preliminary clinical pathology report on the leg. Spleen results showed no abnormalities.I had never talked to anyone at all about the cost of my surgery or an estimate. It didn't matter, and I knew they would take care of me. I held my breath as I pulled up his billing record. The other Great Dane I looked up previously's surgery was $2,400. I literally held my breath. I would be getting the $1,000 credit. I wonder how much I would owe?

$1,300. That's it. With the $1,000 credit...my total bill...for diagnostics, surgery, and chemo...came out to $300.I made a facebook post about how GRATEFUL we were to get this discounted surgery, $1,000 towards it, and free treatment afterwards. 

Tuesday, we check the clin path report again for any updates. Reading through it I see that the oncologist submitted the leg for osteosarc testing, but also asked for the presence of mets in the lymph nodes? I didn't even know this was a possibility. Why were they asking this? I read out more prelimary reporting and saw that the report said "presumptive osteosarcoma in the lymph nodes". What? 

I called Dr. K to read the report and explain it to me. She called shortly afterwards and told me it was bad news. They saw cells in the LN that resembled cancer. The leg takes awhile to decalcify so those results weren't back yet, but if the cells in the leg match the cells in the LN, that meant the cancer had already progressed. I asked if this meant I was out of the oncology study, and she said yes. I asked how she knew, and she said she talked to them before calling me back. I asked, if the cells don't match, what that would mean. She said it could be histiocytes which are totally normal, or another cancer. Additional testing would be required to determine that, but more than likely, it was cancer.

I broke down. I had been so grateful. And now I'm being told his MST went from 11mos back down to 4mos. I was devastated by this news. The next day, I went to oncology. I asked if I was still in the study. She told me I "was not doomed yet". She told me prevalence of osteosarc in the LN is usually only 4% liklihood. What? Really?? This gave me hope. She told me she had already put in for the additional testing to determine what was going on with the LN cells. We had to be patient. 

Now I wasn't going to get the $1,000 credit and would have to figure out how to pay the surgery bill. And now I wanted Oakley to have the best treatment, so I would have to find a way to pay for chemo too. The cancer didn't make me cry. The amputation didn't upset me. But my gratefulness and hopefulness being crushed...and Oakley going from a year back down to 4mos...

A few days went by and I checked the clin path report waiting for an answer. On Saturday, there was an addendum. I read it. But it's in medical jargon code. I was pretty certain it said final report, no mets in the lymph nodes. I e-mailed the oncologist (another thing I am grateful I am able to do). She wrote back Saturday evening. Oakley was BACK IN THE STUDY.

I cried so hard from happiness. And earlier this week, on Monday, $1,000 was applied to my hospital bill. And Oakley received his first round of chemotherapy. The bill was $508. And it was covered in full. We were assigned "control" group, which means no rapamyacin, and we are totally cool with that. Oakley seriously ran through the halls of the hospital. He is getting around so well, 10 days post-op. On Monday he also had his sutures removed. Incision looked great.

Today is Wednesday. The chemo was well tolerated. No side effects so far. But today...I got home...and noticed a big wet reddish spot on the bed. He was licking...and it was bloody. I took him outside to investigate. As he stood in the sun, serum and blood was DRIPPING from his incision site. I panicked. I sent a pic to Dr. B and Dr. K. Dr. B called me immediately. As soon as I answered the phone I realized I should probably calm down and try and stop the bleeding. Dr. B agreed. It was probably just a seroma , I don't know, but as soon as I layed Oakley on his side, the oozing stopped. And I've been keeping an eye on him tonight. I will take him in the morning to check. There might be an infection. Antibiotics, or, if it gets that serious, draining the wound. 

There's no way anyone read this whole thing. But if you did, thank you for letting me share my story. And if you have any questions, please feel free to ask.