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.

Sorry we've been out... WALKING!

So... bad news and good news.
Bad news is - I've been waaaaay negligent in updating Koda's blog.
Tsk tsk! Sorry!
Good news is - Koda and I have been busy taking long WALKS, which is why the blog hasn't been updated!

It's been over a month since the last post and Koda's been working his little atrophied muscles with twice daily walks down our long street and back. He always starts off with gusto, but I always hold my breath on the return... dread weighing on my heart if he were to start sitting down frequently or holding up his re-hab'ing leg.

But my worst fears have slowly been replaced with sighs of relief, as with each completed walk, Koda has only needed to sit down once or twice. But from being out-of-breath and not because his leg hurts. He sits for just a few seconds—literally—then pops back up and continues his walk with pep and vigor. Besides being out-of-shape, the warmer temperatures slow him down a bit too. All that fur.

Here's the x-ray from Koda's last follow-up visit with the surgeon. Everything looks great! No inflammation of that CCL tendon. The "cut line" where the tibial head was removed and rotated has completely healed. And the holes that were drilled into his leg bone to secure the metal plate are filling in nicely with new bone tissue. So now the leg bone is less fragile. Hurray on all accounts!

With that, Dr. Munjar felt his legs and just remarked that his left quadricep muscle is "very puny" and needs a lot of exercise to build it back up. So he discharged Koda with an aggressive exercise regiment of twice-a-day walks, incorporating hills, trails and switchbacks. Even some off-leash play at an uncrowded dog park.

So we've been out walking... and walking...



And even a little running! Yes! Koda is running again!



But he gets winded pretty quick, so he stops to just sit and enjoy being outdoors. After being cooped up in the house for months, this must be heaven to him. (Oh! And by the way, we got to remove the baby gates - giving Koda free reign to go up and down the stairs all he likes.)

When we're not taking walks, Koda hangs out in the backyard. What do you do if you're a husky in summer? You dig yourself a ditch in the dirt and curl up in it to lounge away the day.

Well, we're going to get back to walking and hopefully we'll have more happy news to report in a couple weeks! Thanks for reading and for all the support!

Stitches Out (again) & First Walk

It's now been 16 days since the hardware removal surgery. Koda had his check-up visit with the surgeon and the stitches removed yesterday.

Watch that left leg move!

Dr. Munjar said his leg felt good, and the area which was painful when probed before (where the bone plate was) no longer seemed to be causing Koda pain. All good news.

Just from my own observation, Koda has been in a pretty good spirits the last 2 weeks. I think he really does feel better without the bone plate implant. He is walking more "solidly" too. He still has a slight pivot - which is from quadricep muscle atrophy in that left leg. But the new regimen of walking will serve to strengthen his muscles and get him back into shape for all the things that a middle-aged dog likes to do.

No stitches here!

Dr. Munjar said to go for 10 minute walks 3x's a day through the weekend. Today we managed 2 walks. On the first walk, 14 houses - NO SIT STOPS!!! I was nearly holding my breath as he walked past one house after another, turned around and made it back home without any stops! His second walk was 19 house lengths, but he did have to stop and sit at house 9 and 11. I'm not sure if it was his leg or him being out-of-shape. So I guess more walks will give us a better idea of his leg condition.

Next week, we are supposed to increase to 15 minute walks 3x's a day. These walks are kind of the "proof is in the pudding" tests. If he is able to ramp up his walking, we'll know he is on the way to a full recovery. If he still has to sit down, it will be heartbreak again, as we would have to pinpoint what is wrong.

11 Days after 2nd Surgery

Post Op #2, Week 1 update: Koda is doing really well! He's walking (dare I say it) better than he was 7 weeks after his TPLO surgery. When walking, he "plants" the left leg more solidly, and it doesn't seem to splay-out as much. This second recovery phase has definitely been a bit easier than the recovery phase after his first surgery. While his leg is still fragile because of the 6 holes in his leg bone, it's not like the tibial head and tibia bone are severed. That part of the leg is healing nicely. This recovery period is for the 6 holes to fill in to solidify his tibia and for the incision to heal, which is "just" a clean soft tissue cut.

Koda refused ice treatments on his leg. And after 3 days, didn't appear to be in any pain, so I stopped his pain killers. Well, that and because he refused to eat them anymore.

Yeah, giving him meds became a big production with lots of foaming and spitting drama...

Because Koda had so many meds to take - anywhere from 1-3 times a day, I had to get creative. His anti-inflammatory meds and glucosamine chrondointin supplements (for strong bones) were liver-flavored (I gather dogs like this), so I could crush these into his raw meat "stew" meals. He wasn't drinking enough water, so I started adding a lot of water to his meals to keep him hydrated, making more of a stew.

But I couldn't mix the antibiotics and pain killers in his food because they were bitter, and once they got wet, the bitterness permeated and he refused to eat his food. I think I wasted a couple doses discovering this, as he left his bowl after one taste.

Medication Tricks:
Because dogs go mostly by smell, I added some wild fish kibble to each of his pill bottles, so that the meds would take on the smell of the kibble. Then we'd play the Kibble Treat Game, where I rapidly toss kibble for him to catch in his mouth and then sneak in a pill in the rapid succession. Because he was so excited about getting treats, he'd just swallow quickly.

Going with this "smell masking" idea, I'd entice him into his kennel with the promise of kibble and then mix a few of his meds in a handful of kibble and bits of chicken jerky. Usually he was so excited to eat the kibble that he's just wolf down the pills too. But then he discovered the icky taste of the pain killers because he used his tongue to lick up the kibble/pills. Foiled.

Other times, I'd prepare 6-7 cheese "treats", with pills in two of them and do the same rapid cheese treat dispersal: cheese, cheese, pill in cheese, cheese... and so on. Because he was so excited to eat the cheese, he'd just swallow and anticipate the next treat. But this method only lasted a few times. He got wise to the cheese treats. I think the moisture of the cheese caused the pain pills to leach out their bitter taste. *sigh*

After all these methods stopped working, I was forced to give Koda his meds "the hard way" - which entailed P holding him still, while I pried open his mouth, dropped the pills in the back of his throat, closed his muzzle and stroked his throat until he swallowed. Koda was NOT happy.

Shaved leg and stitches 8 days after hardware removal.

Shaved leg and stitches 11 days after hardware removal, his fur is growing back amazingly fast. In four days, Koda will have his stitches removed and a check-up with Dr. Munjar. I think at this 2-week mark, he may be allowed to go up and down stairs again. Koda has really, really missed the upstairs bedroom. When we go up the stairs during the day, he waits by the baby gates with this forlorn look on his face. I think he will be much happier once he can sleep upstairs again.

Second Surgery - Metal Bone Plate Removed

After a two weeks of anti-inflammatory (Rimadyl) and muscle relaxers (Methocarbamol) without any improvement, it was decided that the metal bone plate in Koda's leg should be removed. Eleven weeks after his first surgery, he underwent his SECOND surgery - to help him recover from the first one. *sigh*

I was able to drop him off for surgery and pick him up the in the same day. At 4:30pm when I came to get him, the techs brought him out and he started thrashing and flailing - still groggy from the anesthesia and confused about his gigantic appendage.

Exhausted and disoriented, he laid down on the lobby floor while the techs called the surgeon RIGHT THEN to see if it would be okay to cut off the bandage (it was supposed to stay on until the next morning).

Cleared to removed the massive cocoon of a bandage.

Lots of layers of cotton to compress his leg and prevent swelling.

Dr. Munjar had cut Koda open the same incision from the first surgery. He said it's cleaner this way and because blood vessels have not yet formed through that scar tissue it's actually better to cut there. If he made a second incision, the strip of skin between the old and new incisions would be cut-off from blood supply and become a sort of "dead zone." Interesting.

The first night home was extremely difficult. When I got him home, he just kept crying and whimpering on and on and on. He was anxious, swaggering like a drunk and agitated. He kept pacing. We have to keep him quiet and NO STAIRS for 2-3 weeks because his leg is even more fragile now that the bone plate was removed, leaving 6 big holes in the bone! They said he could easily BREAK his leg!!!! If that isn't stress, I'm no sure what is! If he breaks it, it will be another surgery and another 8 week recovery!

We tried confining him to his kennel to get him to stay still. He kept crying. It was so heart breaking! Finally, P ended up sleeping on the sofa back in make-shift Camp Koda.

The next 2 weeks will be tough because Koda is not allowed up the stairs. We may cautiously try to "wheel barrow" him up with his backside in a sling. But if he struggles and falls, it would be really bad. So not sure it's worth the risk, even though Koda desperately wants to go upstairs. He keeps standing in front of the staircase, looking up longingly.

Koda will now spend his days, doped-up on antibiotics (Simplicef), anti-inflammatory (Rimadyl), pain killers (Tramadol) and anti-diarrhea/tummy anti-inflammatory (Metronidazole - he'd had a 24-hour bout of liquid diarrhea over Memorial Day weekend, oh joy). If he didn't calm down after his first night home, I would have to give him a sedative on top of the rest of his meds. Thankfully, he appears to be more relaxed today.

It's going to be a tough next 2 weeks. For some reason, I kept thinking the recovery after this second surgery was going to be a breeze. I was wrong. It's still going to be a long haul as we baby step towards full recovery.

Heartbreaking News - 9 Weeks Post-Op

After Koda's 7-week check-up and x-rays, the surgeon said the bone joint looked good, almost completely fused and cleared Koda for outdoor walks of 10 minutes, 3 times a day. The first 5 days, he was doing really well - he'd trot for 6 house lengths, then 13, maxing out at 17 houses and back! He was tired at the end, but making progress.

But then he started having problems - having to stop, then sit down, every few houses on the way back. Finally, on days 9 and 10, he could only walk 4 house lengths and had to stop at every driveway on the way back and sit down. :(

I knew something was wrong.

I made an appointment with the surgeon.

Dr. Mujar had new x-rays done and felt his leg and the bone plate. The knee joint is still healing great - no tenderness, swelling, inflammation, etc. But Koda would flinch and jerk his leg when he pressed around where the lower part of the bone plate is screwed into his leg.

The surgeon said it's not the knee joint, but a "sensitivity" to the metal. Basically, his body doesn't like that metal piece in his leg and it's making his leg achy and sore, which is why he is able to walk less and less. He says this is so rare. Usually dogs with major allergies would be the likely candidates for this rejection. But no, it's Koda. Koda who isn't allergic to anything! He says this only happens to about one dog a year - of all the thousands of surgeries he does a year. Go figure.

The other unlikely reason he mentioned was if his knee had been swollen like a tennis ball after the surgery. In which case, when the swelling went down, all that extra tissue would need to go somewhere and would end up acting like shrink-wrap around the metal plate. So imagine trying to move and having something tight constricting that area. Scar tissue. But since Koda's knee was NOT swollen like that, he said that scar tissue is probably NOT the reason he is having problems walking.

He sent us home with more anti-inflammatory meds as well as a muscle relaxer (his groin muscle is now tight, probably as a side effect of straining to use the hurt leg). If he doesn't improve in a few days, then it will be surgery—AGAIN—to remove the bone plate.

At this point, the bone plate has served it's purpose, as it was screwed in to keep the tibial bone in place while it fused back together. Now that the bone is fused, there is no more need for it. But with 99.9% of the dogs, you just leave it in. After Koda is cut back open, bone plate removed, stitched back up, he'll have 2 weeks of home post-op care like he did before (ice, Codeine, anti-inflammatory & anti-infection drugs) and then the stitches come out. But this time, his activity will not be restricted, as the bone is already healed, so he can continue his walking regiment, etc. That's about the only good part about Koda having to undergo surgery - AGAIN.

Of course, another surgery is NOT what we wanted. But it looks like the only definitive way to get Koda back on track to walking and healing. As there are no other reasons why Koda's walking is getting worse. *sigh*

My heart aches for poor Koda.

7 Weeks after Surgery - The Next Steps

This week was a big week for Koda. He went on a big trip to Eugene (which included long car rides, staying at a hotel and much more walking than his usual meanderings around the house), his 7-week Post-Op check-up with the surgeon and new x-rays, and 10-minute walkies... outside - in the neighborhood! No more of this boring house arrest!


Here's Koda on his second outdoor walk. Watch his rear left leg. He made it down the street (13 houses) and back. He started off with gusto, very excited to be walking in the neighborhood, but on the way back, had to stop three times and sit down to rest on the sidewalk.
I was sad.
He was sad.
He looked at me with sad eyes, as if to say, "Wow. I can't believe how out of shape I am! Would you mind if I rested a minute?"

Here's is my poor doggie, sitting and panting on the sidewalk. The same dog who used to run 10-13 miles with me in Forest Park. If anything, this just reminds me that long lay-offs from activity require patience and time to gradually build back up. We will do what the doctor said, and diligently do the 10-minute, 15-minute, 20-minute, 25-minute walks over the next month, until Koda gets the A-Ok to start running again. And then it will be the same gradual build-up for running. Hopefully, by the end of summer, Koda and I will be out running on a shady trail!

Here is the 7-week x-ray of his knee. Dr. Munjar pointed out that Koda has straight patella tendonitis, and prescribed some anti-inflammatory meds to calm that down. He said it's nothing too serious and that the tendon is irritated because it is working hard to keep his knee cap aligned since the leg muscles are too weak at this point. The new regiment of walking will help strengthen his muscles and relieve the patella tendon.

He also pointed out the new bone growth at the top of the tibia, where there is a "valley" after he rotated the tibial head. Eventually, that "valley" will fill-out with new bone growth.

Conversely, where the tibial head was rotated and extra bone now exists, that "nub" will wear down a little and smooth out as it integrates with his tibia.

All in all, Dr. Munjar said Koda is doing slightly above average in his healing phase. He's not doing fabulous - like some young dogs. But he's also not doing poorly - where the bone is not healing steadily or there are other complications.

6 Weeks Post-Op - Goofing Around

Koda is walking close to normal these days and feeling spry enough to fetch treats. He is three-quarters of the way through the bone-healing phase (which is 8 weeks). This past week, I could sense that he considers the less-agile leg a bit of a hindrance to unleashing his new-found energy. He walks steady, pivots & turns, and sometimes breaks into a gallop when he gets really excited. (We have to discourage that for now.) There has been a definite shift in his demeanor. He is noticeably in a better mood (tail wagging), much more energetic and playful. Up until this point, he had no interest in playing with his toys...

"What?"

But when we finally gave him Monkey back to play with, he wasted no time in gutting the stuffed primate and beheading him. He seemed quite satisfied with that play session. The head was easier to fit in his mouth without the dangling body, too.

"Well, yes... the head *DID* come off."

Next, we started testing out the roll-up ramp we bought from Ramps4Paws. It was pricey ($209 on sale!), but we don't want to risk any damage to his knee jumping in or out of the cargo area of our SUV during his recovery or going forward. So we did a little training to get him familiar with it, followed by copious amounts of praise. He is still not allowed to climb any stairs (so yes, this means we are still sleeping on a sofa & air mattress at Camp Koda).

Here is 6 weeks' worth of fur growth. The fur on the previously-shaved foot/ankle is now almost blended into his foot fur. And the fuzzy undercoat is getting thicker by the day. But it will still be a few weeks (heading into summer, how ironic) before he has a full coat on that leg.

In the meantime, Monkey had some radical, life-saving surgery of his own. P painstakingly re-stuffed and stitched the dismembered limbs and head back together. We are going to let Monkey "recover" a bit more before playing with Koda. LOL

Day 30 - Almost Normal

Well, not much to report. It's been about one month since Koda's surgery. I suppose this is the long, boring, uneventful part of the recovery process. While the bone is healing inside, there are not many changes happening visually - other than watching his walk. He is walking with normal alignment and weight placement on both hind legs now. He does appear a bit "creaky" when he first wakes up, but the knee joint loosens up and he moves around the house almost as normal as he did before.

The fur is really thickening up.

Of course, he doesn't have his agility and quick responsiveness back yet. But he tries. He gets excited and sometimes gallops over when I call him. And he does some backwards leap-frogging when he knows treats are about to be doled out. The sparkle is back in his eyes when it's treat time. But we try to keep him calm to prevent any twists or pivoting on that Bionic Leg.

Koda spends his days mostly in the front room, dozing off or looking out the window. Which is what he used to do before the surgery - napping either there or upstairs. So this part of his life is back to routine. But when I open the front door for him to get a few nostrilfuls of the outdoor breeze, I can tell he really misses being outside and taking walks. It will be 4 more weeks before we can venture out for real "walkies" - as we call them.

His incision has healed up perfectly. The hair is growing right over and you can barely feel the scar tissue. He doesn't mind being pet there.

Standing on his still naked-looking "turkey" leg. I hadn't realized how thin his legs are until you take away all that fur. Huskies have a good inch and a half of insulation just from fur!

Stay tuned and check in with us next week. Hopefully I'll have some more video, which is more interesting for seeing progress.

Day 21 - Videos! Walking! Treats!

So after Koda's "staircase (high jinx) set-back" this weekend, some rest, and some anti-inflammatory drugs - he appears to be back on track for his recovery. No permanent damage done (so it appears). Here you can see he's walking pretty well, with his re-hab'ing left leg in alignment while he strides instead of splaying out sideways. As the leg muscle grows stronger, he should be walking more evenly.



And he is in good spirits. Treats always make doggies happy, even finicky ones named Koda. We usually play this find-the-treat game over a bigger area and I chuck the treats far and wide. He thinks it's a gas to scamper around, sniffing to find them. But since he is re-hab'ing, I just toss within a few feet of him. As far as Koda is concerned, he found the treat and they taste yummy. More please!

Weekend 3 - Stairs & Set-backs

I suppose everyone gets tempted. After 3 weeks of not being allowed upstairs (where Koda used to sleep in our master bedroom), he succumbed to the siren's call of STAIRS.
"Come up! Come up!" she called.

We just went out to get some pizza and based on Koda's track record of good behavior, we continued to let him have the entire downstairs floor to roam around as he pleased. We just barricaded the staircase. He had never seemed interested, nor tried to jump up on the baby gates to get a look beyond, so we thought we could trust him.

We were wrong.

When we came home, we were greeted by a happy 3-legged hippity-hoppity dog! O.M.G.!!! What happened?!?! Even his first day after surgery, he was not hiking his leg up like this - refusing to place ANY weight at all on the re-hab'ing leg.

I was completely distraught. The only explanation was that he got bored and without watchful eyes around, attempted to jump the barricade and climb the stairs. What if he'd fallen on the stairs?!? What if he damaged the still-healing bone?!? What if? What if?

I had to call the surgeon on his cell phone at 9pm, the night before Easter! He told me to ice pack Koda's leg and he'd call in a prescription for Rimadyl (anti-inflammatory) for us to pick up in the morning. He assured me that unless there was bruising on the leg, probably no major damage was done - that this would only be a set-back for Koda's recovery.

On Sunday, we decided to play it safe and locked Koda up in his kennel while we went to church. He sometimes sleeps in it, but never with the gate in place. So this would be new for him (at home). At the boarding camp he goes to, he sleeps in a kennel, so this whole experience should not be unfamiliar to him. Knowing he would be out of trouble for a few hours, we could have some peace. Being confined would also restrict his activity, allowing his injured leg (and still-good leg) to rest.

Lesson learned: Huskies are not completely trust-worthy. Ha!