Sunday, February 22, 2009

A Few Good Days: A Zoey Update

Since Wednesday, Zoey has had a few good days.
On Thursday morning, I took Lily to the local vet for her shots, and when I came home, Zoey actually got up and hobbled out to greet us.
She not only ate the treat the vet sent home for her, but then proceeded to wolf down a half-can of chicken chunks in broth, courtesy of Nutro.

On Friday, just before Shabbat, the Vetinary Surgeon from the emergency hospital called to discuss the reports from the CT scan by the radiologist and that of the pathologist on the biopsy. The radiologist report stated that they did not think the cancer was actually in the ribs, but certainly went between them, and that the tumor is very big, meaning that although surgery can be attempted, the surgeon is unlikely to resect the whole tumor and that clean 3 centimeter margins are not possible. In fact, it is possible that the in an attempt to get as much as possible, the chest cavity would be breached, requiring more days in hospital and a chest tube and increased risk of infection.

The pathologist report agreed with the best hypothesis of the on-site oncologist: this is most likely hemangiosarcoma, less likely a soft-tissue sarcoma (it is not acting like one) and least likely an atypical bone cancer. The prognosis with surgery and chemotherapy (since they would be unable to get clean margins), is an average survival time of six months to a year, and in Zoey's case the smaller number is the more likely because of it being a Stage 3 (very malignant and fast growing) cancer.

The surgeon laid out three options:
  • surgery with chemotherapy (we'd be facing this again in about six months)
  • make her comfortable with pain management (prognosis of two weeks to a month in her best clinical judgement)
  • euthanasia

We told her that we are leaning towards the second option, knowing full well that at the end of that road is the third option, but that we would contact her on Monday with any other questions and a decision.

As we sat in our pre-Shabbat bath, we discussed some more, and reluctantly concluded that we cannot put Zoey through risky surgery only to face this again in six months. We also concluded that we would not go through multiple regimes of pain medications. She came home from the hospital on three meds, which had given her two good days. When they cease to be effective, it will be time to put Zoey down, hard as that will be.

Shabbat dinner Friday night was a roast, with mashed potatoes and gravy. One of the Engineering Geek's express wishes was that Zoey should come put her muzzle in his lap, asking for a treat. And she obliged him. (I tell you that she can read your mind. Or at least smell the beef!) She hobbled out and ate quite a lot of the juicy bits, complete with Challah dipped in the clear gravy.

On Shabbat morning, the Chem Geek Princess brought the Granddog Ruby out, and the Engineering Geek and the Boychick took Ruby and Lily for a walk as part of our scheme to socialize Ruby to Lily (both are nervous about other dogs, unlike our beautiful Zoey).

Zoey was so upset that she could not hobble fast enought to go that I brought her outside to sit with me on the porch while I prayed the morning service. Here is Zoey smiling in the warm sunshine.
Our porch faces southeast, and so the morning sun is reflected off of the stucco wall of the house, warming the porch nicely, even on cold days. Yesterday was a warm day for February and the porch was quite toasty-warm. It felt good for both man and canine!

Later, when her people and other dogs came home, Zoey got positively motivated, spending a few minutes watching Ruby jump over the low door-garden wall, and then she decided to dig up a chew she had buried on some long ago summer's day.

Here she is digging, a favorite pasttime that has been absent during the last six weeks.
We watched with a bittersweet sense of impending loss; the digging was a sweet reminder of better days, but Zoey's poor shorn body, the grapefruit-size of the tumor, the trembling left leg, and the arched, painful way she holds her back, all reminded us that this normal Zoey behavior was a temporary respite from the weary toll of her illness.

And indeed, last night, worn out from the days adventures with Lily and the Granddog, Zoey had to be hand-fed, she paced in pain a full hour before she was due for her evening meds, she could not settle.

She did sleep, finally, at the foot of our bed, where she seems to find comfort in our nearness when she awakens in the night. She got up twice for two painful trips outside, and then to the kitchen for a drink (she refuses to take food and water from anywhere else).

This morning, she had great difficulty getting up. When we got up, she took over the center of the bed for a few minutes--another fleeting reminder of the Zoey normal--but today she has slept and slept, although she did eat some yogurt for breakfast, and some dogfood with cheese for an afternoon snack.

Today was at best a mediocre day. And the tumor is growing still.

Although I cannot imagine our house without my Zoey, I do confess that I looked at the pictures of adoptable dogs from the local shelters on-line. But I kept thinking that this one or that one had ears like Zoey's, and that this one or that one would do well with Zoey as a mentor.

And then I'd remember. Zoey won't be there when we add another dog to the family. And then I cry. And Lily, that needy love-hound, would come up and lick my tears as I sat, stroking Zoey's velvet soft fur.


Mama Monkey said...

As always, I am holding you all in my thoughts. My father was faced with the same choice when his dog was recently diagnosed with cancer. He basically chose the same option you did. It definitely seems to have been the right thing -- they had wonderful time together at home, not imprisoned in a vet's office going through chemo, and she enjoyed her remaining time on earth very much. HUGS.

Rational Jenn said...

I'm so sorry. HUGS.


And, completing the circle, there will come a day when you realize that your pets will probably outlive you.

Hugs also.

Susan Ryan said...

So sorry to hear about your Zoe. This happened with our sweet boy Chocolate. Our family had lots of tears too. It's hard being a mom and just not being able to fix it.

We had some comfort knowing that when we got him from the Humane Society, he had a wonderful life out here on the farm. I am sure that Zoe had the same and you will have no regrets. But there will be that terrible sense of loss and habit when the time comes.
She's in great hands and you'll know the best to do for her during this time. She knows that.


Melora said...

I'm so sorry, for you and for Zoey. I'm glad that you are able to be with her and make her last days happy ones, though.

emma said...

i had to have one of my cats put down about two years ago. i still miss him. It's one of the hardest things to do, even when you know it's the best for the animal.

Hugs and prayers for your family during this difficult time.


christinemm said...

I am so sorry to hear of Zoey's pain and suffering. It is a hard decision to decide how to handle it. I made the same decision for my cat in 2006. I couldn't take the suffering any longer.

Your post touched me, it is so emotional.