Quality of Life

Since the last blog post on Tuesday, things have drastically turned for the worse. On Wednesday, Koda started to have a lot more trouble breathing... and by Thursday afternoon, seeing him struggle for each breath - with the sound of mucus congestion in his lungs - has become more and more unbearable. Unbearable to know he is suffering. Unbearable to watch his heaving body and listen to his raspy breaths.

I spoke with the specialty vet who is overseeing Koda's hospice care and he told me what I didn't want to hear, what I was afraid to hear. Koda has days to a week left... but he could also suddenly go into respiratory arrest and suffocate to death. Knowing firsthand how Koda is doing, I have to ask myself, "What is Koda's quality of life now?"

I know the answer.

I spent most of Thursday dealing of other household crises, while continuously bursting in to tears. I told Perry my decision and he agreed. With a fractured heart, I have made the hardest decision of my life. And this weekend, we will be enduring unspeakable pain while we say our goodbyes to Koda.

Thank you for reading, caring and for your support. I don't know how life will be without Koda... he's such a huge part of my life...

Koda's made it to Week 7

Sorry for the lapse in Koda updates. My folks came up to stay with us for the week, so I wasn't online much. They came to spend some time with us and to visit with Koda... for the last time. They said their goodbyes after I took this photo.

Koda is hanging on! He's now made it 7 weeks past his cancer diagnosis. He is at a strange plateau. He still has a healthy appetite for his raw meat & veggie meals - nicely blended for easy slurping. He has only lost a few ounces of weight in the past two weeks. He can still go out and do potty by himself. While he has increasing trouble getting up and sitting down, he can hobble around the house at will. And he comes when called for meals or medicine time.

The sad news is that his breathing is becoming worse and worse. We can see him laboring for each breath, heaving and panting. He sounds more mucus-y and raspy when he breathes. And walking in from potty makes him short of breath, his heart pounding loudly. He coughs from time to time. All of this is really hard to watch. And then knowing it will only get worse as time goes on...

Almost 2 weeks ago, he went in for a nail trim. At first it was quite an ordeal for Koda - he howled like they were torturing him when they hadn't even touched his feet yet. The vet techs kept saying, "Remember the breed. Remember the breed." Huskies have a reputation for being big cry babies. Eventually he calmed down and tolerated the pedicure.

The dremel makes quick work of filing down thick nails.

His nails were quite overgrown and probably making it hard to get a steady paw/foot plant on our hardwood floors. They also trimmed the long fur that grows between his pads and toes, to make his steps less slippery. I think this has helped him with walking around the house.

Giving him his meds has been status quo. Seems like the routine we have works. Koda still loves yogurt and ice cream. The nice lady at the holistic vet suggested baby food and spoon fed him a sample when we were there. Surprisingly (or not surprisingly), Koda likes Gerber Chicken & Chicken Gravy baby food! It's cool, creamy, and tastes like chicken - so what's not to like? (But he has lost interest in string cheese and chicken jerky now.)

Koda spends time in the evenings lounging on our front lawn, just watching the neighborhood activity and sniffing the breeze. Since it's been warm, it's been pleasant outside at dusk. Once in a while, Koda will get a wild hair and head off to one of the neighbors' homes to visit Maggie, an exuberant black lab-mix, whose whole back end wiggles when she wags her tail. Sometimes he just likes to go lounge on their lawn.

It's comforting to know that he still has "doggie interests" because we are now looking for signs from him that he is too miserable and doesn't want to endure life any more. I search his face and look intently into his eyes to see if he is trying to tell me he's had enough. But at this point, the sad countenance I see is balanced by tiny tail wags and his eagerness to still go for car rides and front yard outings.

Koda's Will to do what he wants

Koda is still with us... he's generally in good spirits, gives us ever-so-subtle tail wags, and comes to full alert when I tell him there's a kitty outside. Some highlights of the past week:

Koda surprised us one night by coming up the stairs all by himself! Unsupervised! He maneuvered around the blockade we'd set up at the foot of the stairs. P was in his office and I was in the shower. When I came out to the hallway, there he was. We didn't think he could make it up the stairs anymore. He proved us wrong. However, since neither of us witnessed the feat, we don't know how difficult it was for him. But he must have really really wanted to sleep up in the master bedroom like he used to, so he hauled himself up the stairs. He was so proud of himself.

Koda completely relaxed on the sleeping bag at Camp Koda.

Meat Smoothies! - Koda still has a good appetite, however I think the various chunks of meat and veggies in his food are discouraging him from eating. I'm not sure if swallowing hurts, or if he just can't be bothered to chew. So I pulled out my hand blender (immersion blender) to whip up a true meat & veggie smoothie for him. The new consistency was much more palatable for him and meal time isn't such a frustrating ordeal. He's been getting up and moving to different locations while I'm trying to feed him - as much as 5 times during one feeding. So I'm following him around with a sloshy bowl of raw food and a spoon and begging him to eat a few bitefuls before he gets up and relocates.

The only problem (inconvenience) with the blending is that the immersion blender is dreadful to clean afterward. Not only is it slimy and greasy from the meat, there's stringy tendon wound around the blade shaft that has to be cut away with a knife to remove. Slimy, greasy mess. Mind you, I hate touching raw meat. I don't even touch raw meat for our own meals. (Thank you Trader Joe's for conveniently packaged meat.)

Medicine time - Perry and I have gotten the routine down pat - so we thought. Yogurt... hold... yogurt... medicine syringe... yogurt... intermission... and a willing Koda returns when we call. This past week, Koda was squirrely for some reason. He figured out a way to weasel out of P's hold by moving his body sideways and ducking his head back towards P's armpit. We had one messy day of syringe med administration. I wouldn't call it struggling, but more ducking out of the situation.

I think it's becoming a "game" of who can outwit whom - Koda vs. Us. I had to improvise and get creative. So now I sit balanced on my tailbone, still facing Koda, holding him still between my bent knees. P is kneeling squarely behind Koda preventing him from backing out, and holding his head still. Between me and P, we have him in a full-body hug, so to speak. So far, this new "hold" is working and we've had uneventful syringe med sessions. Followed by Haagen Dazs, of course.

Other than these things, we feel like we are at some plateau with Koda. He's not declining rapidly, but obviously not getting better. He's a little shakier on his legs and his breathing is worsening - quick shallow breaths and raspy at times, with an occasional cough. On Tuesday (8/16), it will be 5 weeks since his cancer diagnosis.

It's been so long since Koda has been completely healthy. From when he started to become lame in 2009, to his surgeries in spring of 2010, to the recovery time from those surgeries, and now this cancer - it seems like we've been losing Koda for the past 2 years. When I see other energetic dogs playing, I remember Koda when he was full of vigor and health and feel like we've been dealing with illness and recovery for such a long, long time. It's exhausting.

A sleeping bag, car rides, and parks

This past week has been a good one. Koda seems to be in better spirits, a little more alert, a bit more smiling, and even some tail wagging. Not sure why he seems to be doing better this week than last. It could be the increased pain meds. I decided to double his pain meds. He's been groaning a little more when getting up and down, so I thought he could use some more for any pain he's having. The vet mentioned that we'd probably progress to more and more potent pain relievers as time went on. I can only hope that they are helping him deal with the discomfort.

I took him into the vets for a quick weigh-in: 51.3 lbs., down from 54.5 lbs. He's lost about 3 lbs. in the last 3 weeks, despite a relatively healthy appetite. He willingly eats both his raw meals and finishes with some spoon-feeding and coaxing from us. But he's still losing weight. (Thick fur gives a good illusion.) This is one of the few outward signs that Koda is sick. From pictures, he looks like a happy, healthy dog. I hate to think how thin he will become as the cancer ravages his beautiful self.

As a family, we are spending a lot of time together. P is now sleeping downstairs in the family room, joining Koda and I at "Camp Koda." It's been almost 2 weeks since Koda's been upstairs. We just don't think he can make it up and down any more, and don't want him to fall in order for us to find out.

Koda got to go for some car rides and spend some time outdoors at parks and grassy lawns on Friday, Saturday and Sunday. When I look in the rear view mirror, he looks like he's smiling and enjoying the sights and sounds of traveling. On Friday I took him to Gabriel Park, ready to just sit on the grassy knoll and people/dog watch, but the excitement from the nearby dog park perked him up and he wanted to walk, sniff, explore, and sit for the better part of an hour. Just when I thought he couldn't do walks anymore. The leg that had the surgery last year is wonky and pivots awkwardly out to the side when he walks, but he doesn't seem to be bothered by it. It still gets him to where his nose is leading him.

We've also had some good luck with giving Koda his liquid meds. The whole process has gotten a lot easier. Koda comes (tail almost wagging) when we call him to the staging area. He gets yogurt for coming. Perry has a new "hold" that keeps Koda very still so I can squirt each syringe in one quick second. Right before I give Koda the meds, he gets a few more licks of yogurt... then the syringe dose... then more yogurt so he'll swallow the meds... then a little intermission. Surprisingly, when we call him back from his hide-out under the dining table, he trots back over. It's weird. He knows he's going to get more meds, but he still comes willingly. Such a good boy! The last several days, we've been able to get 99% of the meds into him. No drama. And Koda always licks his dish of ice cream clean after it's all over.

Speaking of ice cream, we have upgraded his frozen treat to vanilla Haagen-Dazs now. It has the most calories (270) and fat (17g) per serving. We need to get the most calories we can into him, so what a lucky dog he is! And I think we're going to start giving him ice cream after both medicine sessions.

We are approaching 4 weeks past his diagnosis. He seems to be hanging on fairly well. I'm not sure how much of it is the holistic meds and cancer diet... all the TLC we are lavishing on him... or God's grace. Maybe all of the above? At this rate, it's hard to gauge how long he will be with us. It's not like we can have tests done to see if the cancer is slowing down or the positive effects of the holistic meds. It's hard to make any plans for the upcoming months. So we just keep doing what we are doing - spoon-feeding, meds, spoon-feeding, meds, car rides, park visits and making sure Koda feels loved.

Koda's made it to Week 3

Well, Koda's made it to Week 3 since his cancer diagnosis! He is still acting like himself, but a more slower-paced, sleepier version.

Saturday, July 30 - I think last night was Koda's LAST walkies, in which he can actually walk. He was sitting down twice in front of each house. And then he just started laying down on each lawn to rest. It is so heartbreaking to see that he is no longer strong enough to walk. And just 3 weeks ago, he was walking a 1 mile loop with nary a stop. I can't believe how fast he is degrading.

The reality of his cancer is back in focus again. While we had a good week of him eating and taking his meds, it was easy to think he was ok. But now he is starting to cough more, his breathing is labored - panting rapidly because of his compromised lung capabilities, and he can't do walkies. We've decided to just take him to the park to take in the scenery or sit out on our lawn now. He is having a harder time sitting down now, too. I can start to see a more pained look in his eyes when I really look at his face. I think I'm having a second wave of denial. I don't want to believe that I'm losing my Koda.

Today I went on a trail run and remembered how Koda used to run with me, so strong and full of life that he would be pulling me along. I remember how he'd look back at me, with that doggy grin on his face. He will never run with me again. He will never walk with me again on Wildwood. He has walked the neighborhood loops around our house for the last time. Sniffed the irises and powered up the hills for the last time. Now it seems we are just hanging on, waiting for the next "last times" of other common things - like going up and down the stairs, eating full meals... I know, I should stop. This is just terribly depressing. But if I don't write about it, I think the thoughts will evaporate and soon be lost within the sorrow that no doubt will follow.

Sunday, July 31 - Koda ate well (with positive encouragement), and we figured out a new hold on Koda to give him his liquid meds. More medicine in, less mess. These things are holding steady - status quo. We went to Cook Park again. No walk on the agenda. It was more like a chance for Koda to sit on the grass, sniff the breeze and bushes, and just enjoy being outside. Fly fisherman and dogs caught his attention. But other than that, we has content to almost doze off.

Everyday, I try not to take anything for granted. He can still (barely) make it up the stairs. He still eats all his food. He still wants treats. He still licks his feet clean every night. He can still go out to potty on his own. He is still alert and responds when we call him. He still enjoys affection. I hang onto these realities, that Koda is still with us. But I know his days are numbered and I'm not sure I am strong enough for what's to come.

Koda enjoys friends, the park, and yogurt... medicine - not so much

So how is Koda doing? It's now been 2 weeks and 2 days since he was diagnosed with cancer...

Saturday, July 23 - Koda ate his whole bowl of "Raw Food+" at 3:00pm (I'm calling it Raw Food+, which is the raw meat, veggies, gourmet canned food and Fractional Pectin - I'm getting tired of typing all that out every time and it's probably a detail only I care about.) At 4pm, we attempted to give him the liquified meds. I need to be better about aiming for the back of his throat, because he is able to suck it around his gums and expel it out the sides of mouth. He seems to be pretty alert today. He went out to sun himself on the deck around noon.

Peekay & Jackie visited tonight. They are such sweet, supportive friends. Jackie made her special mac & cheese and yummy chicken. She even cooked a plain drumstick for Koda! I think Koda enjoys having people over, and just relaxed while we watched "Rango" - a very strange animated movie about a gecko with the voice of Johnny Depp, posing as a tough-guy cowboy/lizard. Anyways...

Sunday, July 24 - We took Koda to Cook Park for a sunset stroll. He seemed really happy to be there, sniffing to his heart's content. He even seemed to walk better when he was completely engrossed in his environment. Maybe I'm just being optimistic (delusional?). Here are a few pictures of him enjoying the outing. Except that he can't walk far, we make-believe that we have a perfectly healthy dog.

Lately, Koda has had a really healthy appetite - thank goodness. On Tuesday (7/26), Koda ate half his meals on his own. I only had to spoon feed to get him to finish the rest of them. I'm not sure if he just gets tired of trying to eat... or just wants to be babied, because he eats off the spoon with gusto. It's amazing how things we once took for granted become small victories when disease incapacitates our pet.

So he's been eating 2 regular meals a day, plus treats. I've started steaming fresh kale, mincing it and adding it to his Honest Kitchen veggie mix. He doesn't even notice the added greens - which are supposed to be good cancer fighting veggies. And string cheese is still a favorite. I'm going take him to the holistic vet to step on the scale next week to see if he is keeping his weight on.

But when it comes to the twice-a-day liquified medicine via syringes - it's a drama drama drama... Koda is demonstrating uncanny strength when it comes to his syringe meds now. He can nearly out-wrestle BOTH of us at the same time! It's getting harder and harder to get those meds in. And while I want him to be docile while I do the syringes, I'm kinda happy that he has so much will and strength to fight us on it. It would be far sadder if he just listlessly opened his mouth.

Yeah. That's the thick brown medicine smeared all over his pretty white fur... and all over my hand... and sprayed all over P's neck and face. I got to share in Koda's extreme displeasure by sampling the meds first hand. That's right. Some of it got into my mouth and I tasted it. It's AWFUL!!! Dear Koda, I don't blame you for hating this stuff. Yuck!

On Wednesday, July 27 - Ever evolving, we decided to not restrain Koda for all 3 syringes. We are giving him "intermissions" between syringes. We let him "walk it off." Then we added "intermission with treats" and now I offer him licks from a bowl of vanilla yogurt after each syringe... and lure him back to the front door with the bowl. While he's swallowing a dose, I dab yogurt on his lips & peek-a-booing tongue, to encourage him to keep swallowing. This new method seems to keep him calmer and he sort of "resets" himself before each dose, instead of getting more and more wound up. Hurray for vanilla yogurt!

It's amazing how quickly Koda carries on - grooming himself - after all the syringe struggle-fest is over. I come offering a dish of ice cream/yogurt and he laps it up as if nothing ever happened. I doubt his memory is that fleeting, so I can only assume that "all is quickly forgiven" when it comes to dogs.

The NEW "normal"

In addition to the obvious - loving on Koda, spending lots of quality time with him and being "in the moment" with him - the goals of each day are 1) to make sure Koda is eating well and 2) to get as much of the medicines into him.

On Tuesday, July 20, I went to the Holistic Vet and picked up some bigger syringes so we wouldn't have to refill them midway through giving it to him. I ground up the full morning dosage of meds and Perry helped me pry open Koda's unwilling mouth. On the last syringe dose, he moved his head and I ended up squirting some of it right onto P's shirt. And Koda proceeded to shake his mouth and splatter the brown stuff all over our white living room carpet. Oh well. At least we got most of the meds in him. I rewarded and praised Koda with more string cheese and a chicken treat after that drama. He's just going to have to get used to the syringe routine. It's here to stay.

The evening ended with a difficult experience giving Koda his syringe meds. He was determined NOT to take them, and clenched his jaws shut. We had to pry them open. But then he'd jerk his head while I squirted, and continue to shake his jowls so the liquified meds got all over the place. Disaster. P and I are frustrated, but not giving up. As we cleaned ochre-colored stains off our clothing, I told P it was still a successful day. Koda ate really well and we were able to give him 99% of every single dose of today's meds and pain killers. And Koda is still with us. That makes it a successful day.

Tomorrow will be another day. Lord, give me the strength to make it through tomorrow.

Wednesday, July 21 - Reality check this morning. Koda is really not feeling well. He seemed more lethargic today. He didn't come downstairs this morning, just laid around upstairs with a dull look on his face. I have a sick feeling in my stomach.

Koda "slept in" so his first meal was a lunch of raw + veggies + canned trout with the Fractional Pectin powder. He ate it from my spoon like a champ! For some reason he had no interest in kibble or cheddar cheese at all today. Strange. I rewarded him with a whole chicken treat - which he choked on. Lesson learned: must only give him the chicken jerky when broken into small pieces. He got string cheese (still likes this) and later a snack of cottage cheese and yogurt.

Koda came into my office for some lovin' later in the afternoon. He was actually "smiling"! Then when I got back on my computer, he left and went into his kennel for a nap. The cancer really seems to be taking it out of him at an aggressive rate. I can see the difference in him from day to day. It is really heartbreaking.

After last nights medicine debacle, we were NOT looking forward to giving Koda his liquified meds today. We had some new strategies in mind this time. I wore an apron, new jaw-prying techniques... and having him sit next to the front door. Why? Well, splattered medicine goop is easier to clean off the smooth-surfaced door and not the wall. And two, we can box Koda in against the door with our bodies so that he can't squirm or jerk his head around - increasing my success rate of getting the meds down his throat. This worked pretty well. Yay!

Koda had a good appetite in the evening and nearly finished his entire bowl of raw + veggies + canned trout. Lots of praise, vanilla ice cream and chicken jerky followed. I breathe a sigh of relief every time he finishes a meal or takes in his meds. It's the only part of this cancer fight that I feel I have some control over.

Thursday, July 21 - We used the "front door" method this morning, and only had one misfire - which smeared and stained Koda's pretty white face. But overall, the process is getting faster and smoother. Thank goodness. We were saying we could use something like a horse racing starting gate for Koda. Quickly forgiving all trespasses, Koda eagerly accepted my peace offerings of string cheese and chicken jerky after the ordeal.

Walkies: Tonight, Koda barely made it down the street and around the corner, sitting and resting at nearly every house. It is so sad to watch this. Just 2 weeks ago, he was doing his usual 1 mile route with only 1-2 stops. He's really gone down fast. It's during these walks that we remember how sick he is. I hate thinking about this.

Friday, July 22 - Koda has had a surprisingly good appetite all week - which is a relief. He's been eating 2 meals a day of raw meat with veggies and the Fractional Pectin. Today I bought some fresh kale, steamed it, minced it and added it to his bowl. I'm spoon-feeding him every bite, as well. But he finishes each meal and gets rewarded with something yummy. String cheese, vanilla ice cream and yogurt seem to be his favorites.

P says it's starting to settle in now, and he feels bad about Koda. He's dealing with it in his own way (you'd have to ask him). I think I've moved into the state of acceptance and just making sure I get food and meds into Koda. Task mode. I think I cried so much the first 3 days that now I just keep myself from being emotional. It's too hard to function that way, and the way this week has been work-wise, I need to function. And I think it's confusing/disturbing for Koda to have a mommy who is so emotional and crying on him.

Holistic Vet Clinic, medicines and hope

Monday, 11:00am - Appointment with holistic veterinarian, Dr. Bob Ulrich. I told him the situation, he examined Koda, and said he could feel the tumor - guessing it was about 4 inches wide. Then he talked to me about cancer and how nasty it is - particularly hemangiosarcoma - which Dr. Franklin (internal specialist) thought Koda most likely has.

It was rather fascinating to learn about how cancer grows, what it needs from a host to live and thrive, "cell communication", free radicals, cell receptor sites, and then how science has figured out how to stunt it and starve it, etc. First, diet is really important and recommended what he calls a "cancer diet" - which is high in protein and fat, but very low in carbs, or grain free. Cancer likes carbs and prefers them as an energy source. So we want to starve the cancer. Because Koda is already on a "raw" meat diet with veggies, we are on the right track. Dr. Ulrich urged me to add steamed broccoli and kale because those veggies are particularly good for fighting cancer. The cheddar & string cheese, yogurt, cottage cheese, and chicken jerky treats are all approved. While we want a "clean diet", we also want to keep Koda from losing weight, so we want to feed him lots of extra calories from foods he enjoys.

He advised me to stop all heartworm meds, flea treatments, the doxycycline for his gingivitis, and even the Rimadyl. Just use the Tramadol for pain. We want to clear Koda's system of as many chemicals as possible right now.

Next, he went down a list of EIGHT different holistic supplements, medicines, and herbs he was recommending for Koda. It was mind-boggling (I'm not even going to name them all here). Each one does a different thing - like scramble the cancer cell's communication, block receptor sites, kill off blood vessels around the tumor, stimulate his natural immune system to make more T-cells, make cancer cells more visible to his system so it would attack them, etc. One that they highly recommend is called Vet-Immune Tabs, a potent immune enhancing combination of "Transfer Factor" (increases natural killer cells), 11 power mushrooms, IP-6, vitamins, minerals, amino acids, probiotics, essential fatty acids, MSM, choline, glucosamine, penne canniculus, boswellic acid, super oxide dismutase, tumeric.

I like the idea of arming a body's natural immune system to fight the cancer.

I took home $500's worth of herbal medicines. (Ouch! Not cheap!) It's was quite overwhelming, looking at all the pills, capsules, powders and tinctures that I need to get into Koda. I have a matrix chart and it will just take time to get adept to giving the correct dosages for morning and evening.

Once home I offered the tablets that were supposed to taste like treats to Koda. He spit them out. Ugh. He's so picky! So I ground them up, mixed with water, and shot them down his throat with a syringe and P's help. Not fun for Koda. But it might be the only way to get them down quickly. It's just a lot of work and Koda hates getting them.

At least now I feel like I can actually DO something. Lori, at the Holistic Vet, said her dog had metastasized hemangiosarcoma and she used the holistic meds and was able to extend her life for 16 months! And only in the last month did she really decline. So there is hope! This is going to be more than a marathon... if we can stunt the cancer and keep Koda with us for another year - it will be like an ultra. Looking at all the meds and how all-consuming his care will be, I am really feeling like the care-taker of a terminally ill cancer patient. Your mindset changes.

That evening, we bought a mortar & pestle to make grinding all the medicines easier. And it really helped. I'm not even going to mess around with trying to hide the pills or capsules in food. It's "easier" to just grind them up, add warm water and use a couple big syringes to quickly squirt it down Koda's throat. He doesn't like it, but isn't sputtering, coughing, or vomiting - so I think this method will just become routine. It takes both P and I to administer the syringes right now. But maybe it will get easier and one of us can handle it later.

Koda ate really well today and was in a good mood. More smiles and tail wags. He ate all of his 1/4 chubb of raw food, WITH the Fractional Pectin mixed in. Fractional Pectin blocks the attachment of cancer cells to healthy tissues at new locations. Basically makes it harder for cancer to spread. I tasted the powder to see if it would taint the flavor of his raw meat, but I couldn't taste anything - so in it went. Tramadol-filled cheddar chunk, chicken jerky, string cheese. All good. After his evening syringe meds, he was rewarded with more string cheese and chicken jerky. Gotta keep feeding him lots as long as he has an appetite.

Emotionally, I'm doing much better. I feel like I am doing something for Koda. I am helping him fight the cancer. We aren't just sitting around waiting for him to deteriorate and die. We are equipping his body with things it can use to fight the caner. I'm also strengthened by the fact that P is really on-board and is a partner in us trying to help Koda. It will take both of us. It's a lot of work. But we may discover a deepening in our relationship through this season with Koda.

A pretty-good eating day for Koda

In the morning Koda comes over to my side of the bed, just as I'm stirring awake. He wants affection, pushing his face into my hand as I stroke his forehead and face. It's an intimate time for both of us. After a few moments, he just lays down beside the bed until I get up. I am going to miss this routine so much.

Around noon, I was able to successfully give him a Tramadol-filled cheese treat, Rimadyl and 3/4 C. of kibble... and a chicken treat. His appetite is pretty good and he is more alert these past two days. Very happy about being able to get in both meds without any rejection. He'll feel better for the rest of the day because of it. He's not coughing. He still hesitates when he looks up the stairs - where I know he wants to go. But he's is unsure and I tell him "uh-uh" and he goes to lay in his crate instead. Good dog. He actually "self-regulates" pretty well.

I got him good and hungry by watching me eat dinner first, while slipping him bits of warm chicken. That seems to really whet his appetite. He pretty much finished his entire bowl of raw food, with some stern coaxing from me and the promise of cheddar cheese. I'm starting to think standing to finish his entire meal must hurt, because he leaves to go sit down. But after a minute, I can call him back to his feeding station and he will keep eating. I have to spoon feed him towards the end. But at least I got the food into him. He was very eager to get those cheesy chunks - and the Tramadol-filled one went down the hatch without him being suspicious. I hope this cheese disguise lasts forever. He also got 1/2 a string cheese and a chicken treat.

Today was a "good eating day." I might as well feed him as much as he can handle now, because he will eventually lose his desire to eat and start wasting away. So sad. I'm not looking forward to that.

Monday appointment at the Holistic Vet is in the morning. Can't wait to find out what we can do to help Koda!

Cheddar Cheese makes life better

Koda slept most of the day. He likes to sleep in his kennel. I was able to get 3/4 C. of kibble, Rimadyl, and 1/2 a string cheese into him with the Kibble Catch game. He drank a good amount by 5pm. He seems kinda unsettled, like he needs something.

We bought sharp cheddar cheese from Whole Foods. I was able to hide a Tramadol in a chunk of cheese, and Koda ate the pill chunk and the "blanks" (untampered cheese chunks) with little hesitation. He still loves cheese. I just have to be careful about the preparation of these medicated treats. He can taste the powder from the pill when I handle the cheese chunks, and then he spits it out.

In the evening, I took him for "walkies" and he had some pep for about 30 steps, then he needs to stop and rest. Sitting down seems to be painful/difficult for him.

On the way back, we saw Lindsey (who lost Buster 2 years ago, and now has a new Golden Retriever, Penny). She was very kind and sympathetic, even though we've only spoken a few times. Her words were comforting and she told us to whisper in Koda's ears about living until a certain date. She also said that when he passes, she will make a donation in his name to the Oregon Humane Society, so that another dog gets helped. Very sweet. Connections like this would never happen without the common bond of pet ownership... and unfortunately, pet loss. I feel like Koda has brought us closer to people during his life... and perhaps, maybe even through his cancer, we will connect with more people. I'm not sure if this is how God intends to use Koda in our lives. It's painful, but God has his reasons.

Koda ate 1/2 his quarter chubb for dinner. I guess that's good enough considering he ate 1/2 C. of kibble earlier. I gave him ice cream and chicken treats later, too. We are in the state of "getting by" and living in anticipation on his holistic vet appointment on Monday.

I finally stopped crying

I'm finally able to stop crying. I think I'm freaking Koda out and he can sense that something is terribly wrong. We (I) are not acting normal.

Lorinda from Double Dog Ranch sent me an email about a client who boards with them, and her dog "Carmen". Her Carmen was diagnosed with metastasized lung cancer and was only given 6 months to live. She started Chinese herbal treatment and other holistic methods and miraculously extended Carmen's life by 6 YEARS! She said the cancer eventually did spread, but she lived so much longer.

I was floored. And hopeful.

I put a call into the Oregon College of Oriental Medicine (OCOM) and also looked up a local holistic veterinarian. I found one and made an appointment. We are going to get a consultation from Dr. Bob Ulbrich of the Holistic Pet Vet Clinic on Monday. I'm hoping he can prescribe and provide us with a cocktail of herbs that will help Koda's immune system fight the cancer, slow the cancer spread and hopefully increase his quality of life and time left with us. It seems kinda New Age-y, but I am willing to try it. It is non-invasive, non-stressful for Koda and low risk. And it doesn't cost as much as surgery or chemotherapy.

I also found the blog post by a man who's Miracle Pooch "Chuck" experienced the same life-extending effects by using Chinese herbs. His German Shephard/Rhodesian Ridgeback mix was already 9 years old when he was diagnosed with bone and lung cancer. With his owner's TLC and holistic treatments, this dog really defied the odds. He lived 5 years longer! All the way to 14 years old! Which is a long time for even a healthy, large-breed dog!

So I have hope. There must be something in these herbs that can help dogs with cancer.

In the meantime, Koda slept all day (which I forgot he always did when he was healthy too). In the afternoon, I managed to play "kibble toss" with him and got in a Rimadyl, 1/2 C. of kibble and some water.

In the evening, Emily came over and Koda was very excited and happy to have company again. We went for another "stroll & sit" session. He drank a lot at one of the neighbor's water bowls. He did pretty well walking, but only did one spurt of fast trotting. He made it back home with good pep.

Koda did a "good finish" with his raw food for dinner. He got a scoop of vanilla ice cream and a chicken treat afterward. I'm relieved that he ate the raw food. It's going to be a challenge to keep weight on him. So we are doing what we can to feed him lots while he still has an appetite - well, without him getting upset tummy, because he'd only be too enthusiastic to eat tons of treats if we let him.

Epic Fail with Peanut Butter
Perry and I tried to give him a Tramadol crushed in a teaspoon of peanut butter, using the "hard way" method. Koda sputtered and spit out all over the place. I think I only got about half a pill's worth into his system. So much for peanut butter. He's going to associate it with bad things from now on.

He was able to come up the stairs pretty well that night. I gave him a chicken treat in the bedroom - which he ate enthusiastically.

I am still in shock

I am still in shock. And relaying the bad news to family and friends has rendered me a useless, soggy, tear-soaked mess. I'm even crying on Koda when I pet him. The response from people has been so supportive and loving. I am really touched by the outpouring.

Jackie came over around 7pm. She brought over a gift of chicken jerky from Costco for Koda (and ice cream for us). So nice of her! Koda was in great spirits when Jackie came through the door. He was wagging his tail and seemed very excited to have company. The 4 of us (Jackie, Perry, Koda & I) went on a walk, more like a leisurely "stroll & sit" outing, as I am calling them now. We managed to walk to the "condo circle" on Del Monte.
There was lots of stopping and sitting, but also spurts of very fast trotting. Quite amazing, and I cherish those moments. Koda was happy and alert.

When we got back, we fed him 3 chicken treats and tried to get him to eat some raw meat smoothie. He had a few slurps, then walked away. Jackie had similar luck.

Later, I just plain spoiled Koda. String cheese, doggie cookies, Orijen kibble and then, vanilla ice cream. I hoped he wouldn't get an upset tummy and barf it all up. I managed to give sneak a Tramadol in a chunk of cheese - but I know he will get wise to that trick soon and we'll have to use the less pleasant man-handling method to get medications into him. He hates it. And I hate doing it.

The day ended well, even though Koda really struggled to get up the stairs at night.

Now I understand what the care-takers of terminally-ill people mean when they say, "There are good days and bad days. Today was a good day."

Koda has metastasized lung cancer

Tuesday, July 12, 9:30am - Had a morning appointment to see Dr. Munjar, Koda's surgeon. I'd given Koda some Rimadyl over the weekend because his leg really seemed to be bothering him. Dr. M felt his leg, but it was his spine that caused him to yelp when he pressed on it. He took him back for some x-rays and I could hear Koda yelping holy hell.

The x-rays showed that his knee looked great - no inflammation of the patellar tendon and the bone looked good. But it was other things on the x-rays that were troubling.

There was a large mass pushing his large intestine, causing it to curve around and not go straight out to his rectum - as would be normal. I could see the mass with my own eyes.

But even more disturbing was the chest x-ray. It showed white splotches —nodules— in several places all over his lungs. Dr. M was very concerned about these and told me they could be cancer.

Cancer?!?!?!

We talked about options, like having his colleague, Dr. Simpson, perform surgery to remove the tumor in Koda's abdomen. But first he wanted us to see Dr. Franklin, an internal specialist veterinarian. It's hard to read doctors' expressions and determine if they are playing things down or just naturally stoic because they see so much in the medical world. Or if they don't want to freak out the owners. Hard to say.

The vet tech at the desk asked me how things went and I started crying as I relayed the bad news. She was very sympathetic. She said she hoped to see us back, because that would mean we'd be having the surgery to remove the tumor.

I burst into uncontrollable sobs when I left the building. I just couldn't believe what I'd seen in the x-rays and the news of likely cancer. Shock. How could this be happening?

I stopped bawling long enough to call Dr. Franklin's office from the parking lot. After explaining the situation, they were able to squeeze us in right away. We showed up around 12: noon.

Dr. Franklin looked at the x-rays Dr. M had just taken, felt Koda, then told us he's like to take another set of x-rays. He also said he would need to do an ultrasound of the mass, as well as a guided aspirate (like a biopsy), to try to determine the type of cancer we were dealing with. He probed Koda via his rectum and said he could feel the enlarged lymph node there. Perry had joined us half-way through this office visit. We left Koda with Dr. Franklin after signing-off on a $1000's worth of diagnostic tests. I'd be able to pick him up later that afternoon.

At about 4pm, I returned to the Oregon Veterinary Specialty Hospital to pick up Koda... and see the second set of x-rays. Dr. Franklin took me back and pointed to the ultrasound on the monitor. It was supposedly of the tumor, but to tell you the truth, I couldn't tell what I was looking at. When he brought up the digital x-rays, I could clearly see the white splotches all over the lung area - which in a healthy dog, would be all black. There was a "lacy" pattern with several white nodules of cancer. It had definitely metastasized from the abdomen tumor.

Koda definitely has cancer. And it is advanced. Advanced enough to have "metastasized" or spread into his lungs.
Most likely, the tumor in his abdomen is the "primary" cancer.

But we wouldn't know what KIND of cancer Koda has until we got the results of the aspirate back from the cytologist (someone who studies cells). Without knowing the exact type of cancer, Dr. Franklin could not give me any information about what treatment options we have. With CDs of the x-rays, a print of the ultrasound, and some antibiotic pills in hand, I paid my bill and walked out with Koda.

I lost it again in the parking lot.

Tuesday had been a rough day. I couldn't stop crying. The thought of those cancer cell multiplying and killing Koda every moment was crushing. Now all I could do was wait until Wednesday to find out about the aspirate results and what our options were.

Wednesday, July 13 - I went about my day in shock. I was hoping I'd wake up and this whole cancer thing was just a bad nightmare. But it wasn't.

I took Koda for a walk in the morning. He must've been really worn out from the stress of the office visits and tests. He seemed happy enough to go out for "walkies", but could only make it down 7 houses, having to stop a couple times already. We turned around and made our way back. He had to stop at almost every driveway to sit and pant. So sad. This was a heart-wrenching experience, only made worse by knowing these walks would eventually be remembered as the "best days" he has left.

I waited all day to hear from Dr. Franklin. He finally called around 7pm. The aspirate didn't yield any results. Apparently the tumor cells don't "stick" very well to the needle, so the lab didn't have anything to go on. But he was pretty sure Koda has hemangiosarcoma - which is "a rapidly growing, highly invasive variety of cancer. It is a sarcoma from the lining of the blood vessels; that is, blood-filled channels and spaces are commonly observed microscopically. A frequent cause of death is the rupturing of this tumor, causing the patient to rapidly bleed to death. Dogs with hemangiosarcoma rarely show clinical signs until the tumor has become very large and has metastasized."

Unbelievable.

Our options became this:
1) Re-aspirate (no charge/reduced fee) - but we might not get an answer.

2) Do a 2-cut biopsy ($539-$708)
Cons: Requires anesthesia; vascular risks = massive bleeding
Pros: Better than 90% chance of identifying the cancer

3) Exploratory surgery of the abdominal mass
Cons: Requires anesthesia; Is a major surgery; Stress & recovery from surgery; Risk of infection; Tissue could be too damaged to identify. Costs $3-$5K
Pros: Better than 90% chance of identifying the cancer; Can see extent of it and can take it out - removing the primary cancer mass.

Radiation therapy is out - lungs too close to the heart.
Chemotherapy is only an option if we know what kind of cancer Koda has. So that would require the biopsy or exploratory surgery. And chemo is stressful - 6-8 weeks of treatment for Koda. And very expensive, about $3K.

All of these would involve more stress and risks for Koda. Office visits, procedures, surgeries, going under. There are risks of losing Koda "on the table" during any of this and never having the chance to enjoy the time he has left or say goodbye. There would be multiple risks no matter what we chose. And if we chose to do nothing, Koda would have only weeks to months left. Even if we were to go through with a successful surgery, tumor removal and chemotherapy - we might only extend his life a couple months. And at what cost? Koda's quality of life would be compromised. It doesn't seem worth it.

I hung up with Dr. Franklin and wept. It seemed like the only humane option would be home hospice care. Perry and I decided to lavish love on Koda and try to make his remaining time as comfortable and long as possible at home.

2011 Update on Koda

Every since Koda had his TPLO surgeries (March 15, 2010 and June 2, 2010), his mobility and stamina have not been the same as pre-surgery. His recovery was steady, but he never quite regained the athletic endurance he once had before. He was always happy and eager to go on walks, but it seemed his body could not keep up. I had accepted the reality that Koda would never run with me again.

On January 27, 2011 - I remember a wonderful trail walk with Koda in Tryon Creek State Park. It was an hour long and he trotted up and down the hills with gusto. I really thought he was "making his come back" because this was the strongest he'd been physically since the TPLO surgeries. I had all sorts of hope for him.

In the spring of 2011, Koda seemed to be "slowing down." In hindsight, I think he should have been getting stronger on his walks, but we started only taking him on the hill-less "scary forest" route. It's relatively flat and takes about 40 minutes including potty stops. It seemed that hills really bothered his legs, so we avoided them. I just chalked it all up to Koda's not returning to the same fitness as before, post-surgery knee stiffness, and just getting older. He is about 9 years old now, my guess.

On June 2, 2011 - I'd taken Koda for a walk in Tryon. It was about 45 minutes. We did the North Horse Loop and wound around back to the Nature Center. He slowed down some on the way back, but I didn't think anything of it. He seemed to do much better on trails than on neighborhood sidewalks. I think it may have to do with a more stimulating environment, more to see and sniff.

Five weeks later, Saturday, July 9: Trail walk with Koda in Tryon. It was very hard for Koda, even though we went on easy trail without hills. Within 100 yards, he had to start sitting down. Then for the next 1/2 hour, had to sit down about 8-9 times. :( Something is definitely wrong.

I took Koda straight to Banfield Pet Hospital as a walk-in after the disheartening walk in Tryon. Dr. R saw him. I told her I thought it was the leg/knee, perhaps stiff with scar tissue from the surgery, but wanted to rule out any other physical problems before seeing his doggie surgeon on Tuesday. I asked her about his slight weight loss - about 4 pounds. She checked his weight history and said he was within his normal range. She listened to his heart and lungs - said they sounded fine. Drew blood and ran the tests. She said everything looked fine - couldn't find anything wrong.

I asked her about the blood tests and half-jokingly inquired, "So the blood work is fine and it's not like he has cancer, right?"

She explained that cancer does not show up on blood tests, for some strange reason.

Damn me and my uncanny intuition.