The Decisions

The roller coaster ride of Goldie's cancer diagnosis continued yesterday. We went from words of warning over the summer that it would be very bad if it came back, to reassurances on Monday that it might not be, to fears confirmed from an oncologist on Wednesday.

We took Goldie to the Hope Center for Advanced Veterinary Medicine in Vienna. The morning didn't start off very well, when I had it in my head that the appointment was at 10:30 a.m., and it was really at 10:00. I recognized the error at 9:30 a.m., rushed out the door, and drove straight into traffic.

It'd be safe to say I was a bit emotional anyway heading to the specialist and, well, I'm just glad there aren't hidden cameras in the car to see that I actually broke down in tears sitting there. And this was before I even knew anything.

The Hope Center was very gracious, and even though I was 10 minutes late, I had the full attention of two vets for several hours throughout the day. Those hours were agonizing, as we ordered tests, heard about options, was told several times by the oncologist that (while he supported whatever decision we made), his recommendation was surgery followed by chemotherapy.

We're still waiting for the results of the biopsy, which we should get today, but the cancer metastasized. It is most likely the same cancer from the summer, and even though earlier ultrasounds and chest xrays and looking at the tumor margins came out clear, we missed something.

And now it's in her lymph node on the left side of her groin. The lymph node part is a second reason (in addition to the histamine/ allergic reaction) that it grew so large, so fast.

Because it has already taken over one lymph node, it is highly likely to quickly spread to other parts of the abdomen, and internal organs. We had an ultrasound done yesterday to see if it had already, and that came back inconclusive. A huge, frustrating, yellow light. There was marbling in the spleen and liver, but the oncologist couldn't be sure if the marbling was cancer for certain unless we did a biopsy of the spleen.

The oncologist wants to do surgery to "debulk" the mass -- get that big chunk out. But he in no way thinks that would be "curative," as we had hoped the removal over the summer would be. Since it's in the lymph nodes, even surgery would need to be followed by several months of chemotherapy (once weekly IV infusions for her) to try to eradicate it.

And that's what we just kept getting hung up on. Nothing was curative. Nothing was even a high likelihood of being curative. He kept saying he thought we could get a head of it, and give her several more months, if no new tumors grew.

But there are so many if's and assumptions in his statements that we just aren't able to make. Goldie is, declining. It started with the funny story of the vet saying last year that Goldie "just wasn't applying herself." Then the arthritis. The hearing loss. (We won't even mention the tail.) That she literally sits down if we're out walking her longer than 25 minutes, even if that 25 minutes is at a snail's pace.

We thought we had cured the cancer the first time. But it came back. And it came back in a really bad place, manifesting itself very aggressively.

She was so miserable after the last surgery, the follow up care, the trips to the vet and the poking and prodding. Most of you know her demeanor. You can do anything to her, poking and needles and pulling her ears, and she just lays there with her big, sad eyes. Yesterday, after the ultrasound and biopsy, when they asked me if I wanted to run a test on a sample of the spleen to see if the marbling was cancer, they said they'd have to put her under because she had become so agitated with the technicians with their earlier tests.

Put Goldie under, just for that? It is so unlike her to get agitated with them just for the ultrasound and shaving, that she clearly is scared and upset. 

I can't bare putting her through another surgery, and then taking her in for weekly treatments. She doesn't understand it all. You know?

Every time I think about the decision, I cry. But every time I think about putting her through surgery, the recovery, the e-collar, the trips to the vet for chemo, the needles, the side effects, my entire chest swells up and I can't breath.

When I think about just letting her ... be ... my chest releases.

We are still waiting for the biopsy results. At this point, it could be another yellow light (showing that it may not be related to the summer tumor, that it's a whole new tumor, but still -- a tumor, in the lymph nodes), or it could definitively confirm that it's the same cancer, showing a propensity to metastasize and further confirming in our minds that treatment is only going to decrease the quality of the time she has left with us.

But regardless of the results, and after endless crying and hugging and back and forth, we've made our decision. Fill her with love and treats, let her sleep on the bed, take her with us everywhere we can, and try to make her as happy and comfortable as possible.