Our dog Boo has always been an adventurer, starting from the moment we adopted him ten years ago at 6 months of age. With an acre and a half of partially wooded property to explore, our Great Pyrenees would find new things to investigate on a daily basis. He considers himself the protector of all animals, including wildlife. And if the animals are smaller than him (and they always are), he adopts them. Our animals accepted his protection but the opossums, bunnies and even baby snapping turtles probably preferred to do without his guardianship.
Over the course of his ten years, his adventures haven’t always been trouble-free. He’s been bitten in the nose by a copperhead snake. He felt the wrath of ground bees after stepping on their nest. Fortunately, the emergency vet clinic isn’t far away. And he’s never been graceful, so he frequently tripped over tree roots,stumbled on the gumballs, or just tripped over his own feet. It’s not uncommon for him to have a slight limp for a day or two and then he’d be back to normal.
One recent evening, he raced to the back of the fence to greet the deer that were coming out to forage for the night. As usual, the deer just stared at him with their usual indifference and then continued on with their business. When Boo came inside later for dinner, he had a slight limp. We figured he’d tripped over one of the sweet gum tree roots again and would be back to normal within a day or two.
But his limp hadn’t improved over the course of the next day. Feeling along the length of his affected leg, we found a small, grape-sized lump on his “knee”. We wrapped his leg and made a vet appointment. After googling possible causes,our concern over the possible diagnosis grew.
On the day of his vet appointment a few days later, the lump had already grown slightly. A quick radiograph confirmed our worst fears; he had bone cancer. The x-ray showed a white, opaque mass inside the bone with a “moth-eaten” appearance. The surrounding walls of the bone were paper thin and barely visible compared to the rest of the leg. The swelling we felt on his leg was the cancer mass pushing outward through the bone.
Because the presence of a tumor usually means that the bone cancer has already metastasized, the vet scheduled another appointment to run bloodwork and x-ray Boo’s lungs for signs of any other tumors. The vet explained that this would help help guide our decision for treatment options.
The vet also provided a detailed overview of how bone cancer “works” and how painful it is, why he was confident it was bone cancer,and then patiently explained some of our options and how each treatment might affect our time left with Boo.He advised us to have a family meeting later, and possibly get a second opinion.
Our Options:
- Proceed with cancer treatment which included a biopsy, amputation, possibly radiation, and chemotherapy. Roughly 3-4 months of treatment, extending life up to 12 months or more.
- A biopsy, then amputation without chemotherapy; roughly 7 days to recovery, extending life up to 4+ months.
- Provide palliative treatment for pain until pain can no longer be contained; life expectancy of 1-4 months but sooner if fracture occurs.
The thought of amputation was almost as shocking as the diagnosis of cancer. The vet explained that amputation would alleviate the pain, and because the tumor has eaten through the bone Boo was at very high risk of fracture. He added that most dogs adjust to 3 legs very quickly after amputation. But the thought of our 10 year old dog, who was already clumsy on 4 legs, going through amputation surgery and then trying to adjust to 3 legs was hard to imagine.
The thought of a fracture also scared us so we splinted Boo’s leg. That, along with Carprofen for pain,seemed to do the trick; his limp was gone and he was still happily trotting along into his next vet appointment. They didn’t find any signs of tumors in his lungs, but they cautioned that this didn’t mean smaller (less than 2cm) tumors weren’t present. Boo’s bloodwork came back great. The vet said a biopsy would the best way to know precisely how aggressive the cancer was, and recommended we do a biopsy if we wanted to proceed with treatment (amputation, chemo, etc).
We wanted to do right by Boo. Our other Great Pyrenees died at 10 years of age. We still felt guilt over putting our 14 year old Lab through 2 surgeries only to lose him a month later. At 10 years old and a breed life expectancy of 10-12 years, do we put Boo through a surgery and several months of chemo in hopes of maybe having him with us for another 6-12 months? What would his quality of life be for those remaining months? What would Boo want? Any decision felt overwhelming.
Thankfully the vet put it into the context of how he would evaluate his options if it were his own dog. We felt that he gave us permission to make the decision to focus on quality of life. But that left us with the heartbreaking, painful reality that Boo would only be with us a short time longer.
So now we focus on the time we have left and making him feel as comfortable and happy and loved as possible. It’s been 5 weeks since his original diagnosis. The mass is still there, and there are now several smaller masses that have started to develop further down. He still patrols the yard (wearing his bright pink splint), wags his tail when we come home, and loves belly rubs.
He never lets us know when he’s in pain, but there is a look on his face every now and again that made it obvious the Carprofen alone isn’t enough; so we recently added Tramadol to his pain treatment regimen. The Tramadol seems to make him pant a lot, but otherwise it appears to be helping manage any pain. His eyes are bright again, ears perky and he just looks happy.
Since he’s still in good spirits, and in cherishing every last moment we have left with him, we decided to make a bucket list for Boo. His risk of fracture limits what we can do, but there are still plenty of other options that don’t involve a lot of physical activity. Most involve food, since that has always been his favorite “activity”.
Boo’s journey isn’t over yet. We’re hoping for many more months with minimal discomfort. However, not a day goes by that we don’t second guess whether we’ve made the right decision for him. And not an evening goes by that we aren’t showering him with love.
Four Month Post-Diagnosis Update
Thrilled to update that Boo made it past his 1-4 month “expiration date”. He still wears a splint to support the weak bone, and although the tumor has grown slightly, it has also become more dense. We started adding vitamin D3 to his diet about 3 months ago; for no other reason than if it helps with osteoporosis maybe it will help with a porous bone too.
Boo is still on pain meds and has been in good spirits, and sometimes even gets bouncy and playful like he was as a puppy. But there have been a few rough patches. For a few days around 2 months post-diagnosis, it was obvious the pain was getting difficult.
Boo would keep his head low and preferred to sleep outside during the day underneath shrubs. We celebrated Valentine’s Day a few days early just in case this was “it”. We scheduled a vet appointment. Boo woke up the morning of the appointment with the fur around his right ear drenched in off-white, yellowish fluid. But amazingly, he looked like he felt much better than the previous two days. His ear was clean and there was no odor, but we still kept the vet appointment as a precaution. The vet was unable to find any signs of infection or yeast, but noted that the fluid contained multi-nuceli cells (like cancer). A thorough ear exam yielded no additional information, so the best guess was that a cyst had ruptured. And in rupturing, it relieved the pain that Boo was feeling. About two weeks later, the same scenario occurred with the left ear but quickly resolved.
Outside of the ear incidents, Boo is still doing well and his appetite has even increased a little bit. Now that we’ve passed the 1-4 month prognosis, we no longer focus on how much time we might have left. We’re so grateful to still have him in our lives, and look forward to every day with him.
Fourteen Month Post-Diagnosis Update
Around 6 months into his cancer, Boo’s pain medication was changed from Tramadol to Gabapentin. The vet said the change would help with the heavy panting, and it did. Boo had slowed down a bit (he was older, after all) but was still happy and he looked forward to patrolling the yard several times a day. We even reduced his pain meds slightly because he wasn’t showing any signs of pain or discomfort. His tumor had also shrunk, so we stopped using the splint. Boo had two more bouts with the mysterious ear issue, but those came and went quickly. In fact, most days we forgot he even had cancer. He was a normal, elderly happy dog. Maybe, just maybe, the cancer was gone? Maybe, just maybe, the diagnosis was wrong?
Then one day, the limp returned.
Within a week, the tumor that had previously shrunk was now doubled in size. An xray confirmed that the cancer was growing. We started increasing the pain medication, which helped. But the tumor kept on growing. And Boo’s demeanor changed. His appetite decreased. He lost weight. We were lucky…we were able to spend 10 months pretending that everything was normal; until it wasn’t. Despite not being able to speak, Boo let us know he was struggling. Now, it was time for us to make the hardest decision any pet owner has to make for a member of their family. Fourteen months after his initial diagnosis, we said goodbye.
