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The End.
Thursday June 18th 2020, 8:25 pm
Filed under: Uncategorized  |  6 Comments

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June 18th, 2020.

June 13th was the saddest day of my life.

I started this blog with the intention of documenting my honest and true thoughts throughout Akeela’s cancer journey, so that’s exactly how I’m going to end it as well. This will be my last and final post.

Akeela had her fourth and final round of chemotherapy on June 10th. We had a follow up appointment scheduled in three weeks. At that time, the Oncologists were going to do more blood work to determine if we could start an oral form of chemotherapy called Chlorambucil. They noted that she was otherwise in great health and joked that they didn’t want to see me before our next appointment.

On June 12th I had an end-of-chemo party for her at the new house and invited all her dog friends. We had party hats, pupcakes, dog treat goody bags, pizza and beer for the humans, and most of all – lively spirits. We had all just given our pups their slice of cake and were watching them roam around the back yard.

Choji, Akeela’s boyfriend, was trying to give her kisses and nips while she stood above him on the deck. When he jumped up, she moved backwards at the same time and slipped onto her side. She let out the most awful blood-curdling ear-piercing screams of pain. Pure torture. She was screaming and yelping and looking around desperately and I was absolutely helpless. After what felt like an eternity (which in reality was close to a minute) she finally stopped screaming and just laid there limp. I knew something was very wrong.

I carried her into the house and could see that she couldn’t move her back right leg at all. Dislocated maybe? It was such a small fall, there’s no way it could have been broken. I immediately called the ER vet and loaded her into the car bed. We drove the 30 minutes to Longmont to be at our regular clinic. It felt like the longest drive of my life. Akeela was still eating treats on the drive, so I figured that was a good sign. It didn’t occur to me that that could be our last drive together.

Apparently there were a few emergencies that night, because we waited in the parking lot for almost four hours before the ER vet gave me a call. Her femur had snapped in two. He said it may be a trauma fracture or pathologic. Trauma had the potential of being fixed. Pathologic did not. He said that he wanted to send the x-rays to a radiologist and have Dr. Fowler (our regular Oncologist) take a look in the morning. He told me that humane euthanasia may be an option that I needed to consider in the morning. He referred to it as doing things ‘for’ Akeela versus doing things ‘to’ Akeela. I fell to the floor of the parking lot and cried the hardest that I ever had before.

I did not sleep that night. The only thing that pulled me through was knowing there was a small trace of hope that it was a trauma fracture. If there was any chance – no matter how small – that we could do the surgery, then I was 100% on board. I was already mentally planning how her after care would look. A dog with only 2 functioning legs. How long would her cast be on for? I could sleep downstairs on the couch, since she wouldn’t be able to go upstairs. We could use the front door to go out and avoid the back patio. Thoughts my mind instantly jumped to, because a pathologic fracture was unreasonable.

Shortly after 9 am the next morning, the Doctor called to let me know that Dr. Fowler and the Radiologists had reason to believe her snapped femur was a pathologic fracture caused by the bone cancer. They don’t do surgery on pathologic fractures, because the bone won’t heal. They said they were very convinced it was pathologic, but could only be 100% if they did a biopsy, which would take a week to get results. They said they didn’t recommend going that route, because waiting that long would cause more trauma to her fractured bone and we could risk having her leg hemorrhage. They told me my only option was euthanasia.

After everything we had been through and pushed through, I couldn’t believe that this was our end. That the world could be so cruel. They did CT scans about two months ago when they thought she had a metastasis in her spine. Everything came back clear. They couldn’t see any type of lysis in the bone, until her femur had snapped in two. This came as a cruel twisted surprise to everyone who had been along for her journey. Fuck cancer you fucking fuck. The Oncologist now believes that much of the pain we had been trying to manage with Dr. Downing was likely due to her weak and frail bones that had been eaten away from the inside out.
If you don’t take any action after an osteosarcoma diagnosis, they estimate the dog to live 3 months. If you do amputation you may get 6 months. Amputation and chemo gives most dogs a year. If you’re lucky you may even get 2 years. I did amputation, chemotherapy, rehab therapy and she was still take from me after 3 months. The fates had this in store for us from the beginning. We never had a chance, because in the end … cancer always wins.
The clinic let me come in to say my good byes to her on Saturday morning. How could this be happening to me? Everyone said I was going to have tome to plan. I had picked out an in-home euthanasia service that I wasn’t expecting to use for a year or more. And all that was taken away from us in an instant. I cried the entire drive to the ER. They told me that I could have as much time with her that I wanted. I sat crying and hugging and kissing my baby girl on the floor for five hours. I would have stayed there all day if I could. I brought her favorite toys and treats and hand fed her ice cream. No amount of time was enough. In the end, I couldn’t make the decision of ‘when.’ My mom called in for me. They were giving her morphine every 3 hours or so and at the end I could see it still wasn’t enough. My sweet perfect little angel was suffering.
The image of her leg snapping while she screamed out in pain and the sight of her life leaving her perfect little wolf body are the two pictures I see in my mind over and over and over again. I don’t know how anyone could torture such a pure and perfect soul. I hugged and kissed her and told her she was such a perfect beautiful girl while they gave her the injections – the first one clear and the second one pink, to aid in a peaceful passing. I clung hopelessly to her lifeless body afterwards for as long as I could. I couldn’t believe that she was gone… her body was still warm and her eyes wouldn’t close. I kissed her still little dog face one last time before I left the room.
Every day that I wake up and she isn’t here is the saddest day of my life. I lost my soul mate. My best friend. My other half. I feel like I’m dying. I lost part of myself with her that day. I have a constant stream of tears that roll down my face – sometimes resulting in violent convulsions.
I collected all of her belongings and have them surrounding me in my bedroom so that I can be in her essence. I sleep in her dog bed, fall asleep cuddling with her favorite dead baby toys, smell her socks as often as I can, and at night I’ll sit alone jingling her collar to imitate the sound of her being next to me. I made one of her dog tags into a necklace that I wear with me every day. I have a box of her fur that I hold close to my heart longingly. I even hung one of her rubber non-slip mats in my room because it has her drool stains on it. She would wait for me by the window and drool all over the floor. How sad and pathetic am I that I’m collecting dog drool???
The internet has not been kind and most certainly preys on the weak. I recently purchased a queen size fleece blanket that has a giant picture of her on it. I also invested in a photo pillow that they cut into the shape of your dog. I found plants and trees that you can add ashes to, which I’m also debating doing. And I just sent off some of her fur, so a company can use her DNA to turn into a tattoo-ink mixture. Grief makes you crazy.
I have watched nothing but sad dog movies, because I feel like the characters can relate to the loss I’m experiencing. I also created the worlds saddest playlist that I listen to on repeat (Wiz Khalifa ‘See You Again’ and Celine Dion ‘My Heart Will Go On’ being the real tear jerkers). And the funny thing is … nothing makes me feel better.
I Googled if it was possible for the human body to physically run out of tears … it’s not. It is, however, possible to cry so hard that you die. Apparently the uncontrollable sobbing can cause your heart to swell up and end your life. I’m still not convinced that this isn’t going to be the cause of my ending.
I had pulled the seats out of my Toyota and put a foam mattress in the back for her. Everyone always joked that the FJ was Akeela’s car. Full of white hair and particularly designed just for her. I crawled into her car bed today and cried. More violent convulsions. Today is the 6th day that she’s been gone and I still ugly-cry and sob at the thought of her. I miss her every second of every hour of every day. I may never be able to drive my FJ Cruiser again. It’s a good thing I have a motorcycle to ride instead (sorry mom if you’re reading this …. I have had a motorcycle for 2 years that I never told you about… didn’t want you to worry…).
I was supposed to get a year with her. I was supposed to get to plan it. I was supposed to have time. And it was all taken away from me in a single instant.
My heart is broken. I am not okay. I may never be ok again. I have an Akeela sized hole in my heart. Every decision I ever made was based around her. And now she’s gone. She won’t softly rest her little dog face on the side of my bed to wake me up in the morning. She won’t jam her cold nose into my eye again. I won’t ever hear her soft little breathe-whines. She won’t ever throw her head up at me in expectance when I stop giving her pets. She won’t follow me around from room to room just to be with me. She won’t be waiting at the door for me when I leave or come back from the house. She won’t be shoving her little face into the shower to see what I’m doing. And I’ll never feel her warm wolf body snuggling against mine in bed. She won’t do anything ever again because she is gone. Cruelly taken from me in the most awful and twisted way.
Friends have been sending me white flowers in her honor and every time I go downstairs and see another vase, it breaks my heart all over again. I pulled all of her belongings into my room specifically so that I wouldn’t have any more surprises. My room is where I can mourn and cry and be surrounded by her being. It is far too heartbreaking to be caught off guard by unexpected surprises that trigger more sad memories.
And I am SO GOD DAMN MAD. I scream into my pillow every night but it’s just not enough. I want to BREAK something. How could such a cruel thing happen to her? Why didn’t any body foresee this? Why did she have to suffer? FUCK YOU CANCER. And I can only hear “I’m so sorry for your loss” and “I can only imagine your pain” so many times. Yes well I couldn’t imagine this either. It never occurred to me that I would have 9 months less than I thought with her. But here I am, living my worst hell. Picturing her leg snap over and over and over again while she screams out in pain. After the tragic story that we had so far, I honestly can’t imagine there being a WORSE ending for her. She was perfect. In every way. And I am so mad that this had to be the end of our story together.
My friends and family are as supportive as they can be. It’s not their fault that they don’t understand. That they can’t feel the physical soul-destroying pain that I am in every minute. I’ve been locked away in my room for 6 days and can’t talk to anyone, because their (unintentional) shallow responses just aren’t enough. Akeela was my entire world and they just don’t get that. They don’t know what it feels like to spend your entire life loving and caring for something just to have it taken away from you in the most traumatic and awful way. We were a team. Everyone always associated Akeela and I together. There’s no me without her.
The only people I’ve been able to confide in are people in the tripawds community and a new friend I met named Garrett. People have reached out and explained their recent loss and let me know that my grief is similar to what they felt. And that’s the ONLY thing that helps me feel a little better. Knowing that I’m not alone in my suffering. That someone out their loved their baby as much as I did. Talking to people who feel or felt what I feel now makes me feel a little less alone. Tragedy brings people together.
When I first got Akeela’s diagnosis I remember bawling my eyes out on the whole drive home and having my (used to be) roommate to come back to and get consolation from. I had told my closest friends within the first few days as well. I distinctly remember thinking to myself how I wished I had someone in my life that would be empathetic who could truly understand my suffering and fear. And that made me more sad and feel even more alone than ever.
The day before I moved out of my last apartment a man named Garrett started conversation with me from his back yard. I had lived in that complex for a year and we had never spoken before. He said he had recently noticed Akeela’s leg and told me that he had just found out his dog, Loki, had heart cancer. They estimated that she only had about 3 months to live. We both thought that his dog would be the first to go … and then Akeela took us by surprise. The only thing it taught us was that there are no guarantees with cancer. They can be taken from us at any minute.
I truly believe the dog gods brought us together for this experience. They say people have multiple soul mates in their life time – some are only in your life for a day, others are around for years. I believe that Garrett and I are soulmates and this is the role he came to play in my life. He has been here for me through my darkest of times and I will be right there with him when it’s his turn. He encourages me to acknowledge my dark thoughts and supports every step that I’ve needed to take to try and survive this horrible tragedy. Trauma Buddies. I’m sure it looks unusual to my close friends, who see me spending time with a stranger I just met a few weeks ago. But it’s different when you have someone who understands. Someone whose feeling exactly what you feel. And that’s what I need right now. I eat, sleep, and breathe pain.
When I look back, I honestly believed that Akeela’s amputation was the greatest tragedy of my life. People would ask how she was nonchalantly and I would angrily think SHE IS NOT OKAY, SHE JUST LOST A LEG AFTER 13 YEARS OF USING IT. HOW WOULD YOU FEEL?? For the first two weeks following her surgery I stayed up every night watching her and cried myself to sleep. And then her pain management issues started. That was a whole other level of tragedy. Up to that point, that experience was by far the most traumatizing and horrific that I had ever been through. And now this. Watching her leg snap in two in front of me. Hearing her scream out in pain. Spending five hours with her on her last day. Watching them give her an injection that ended her life. And now the inconsolable grief and suffering that has consumed my entire soul.
I would love to stay locked away in my room with her memories for the rest of my life. Unfortunately I know that’s not reasonable. But the reality is that outside of my room has so much unforeseen and unexpected heart break. I got a package delivered in the mail earlier this week that I had ordered when she was still alive. I have no desire to open it, even though I had been anxiously waiting for it for weeks. I heard Choji, Akeela’s boyfriend, throw up in the next room and thought to myself ‘I’ll never have that alerted sense of panic for Akeela again.’ I have only been able to drink one smoothie every day for the past 6 days, because the thought of food is nauseating. You’d think a smoothie would be innocent enough. But no, even that hurts. The first time I made one, I just stood there looking at my almond butter soaked spoon and cried to myself because I didn’t have Akeela there to lick it for me anymore. She was a part of everything I did every single day. How do you go on without them?
And it breaks my heart to see happy healthy dogs everywhere. It makes me sad and jealous and envious and angry and spiteful because mine was taken away from me. And I would never wish evil on another, but it hurts me so much to see everyone so happy. Everyone else’s life is going on undisturbed and that makes me sad, because my life stopped. I even briefly debated packing up all my belongings and moving back into a one bedroom. The idea of living in this big house (specifically picked out for Akeela) and seeing her dog boyfriend every day is just too much to take. I know they are more unrealistic thoughts provoked by grief, but you try to think of everything you can to make the pain hurt a little less.
Yes, you can say “at least she isn’t in pain anymore” which totally – I agree with. I am happy she isn’t in pain. Pain is awful and she didn’t deserve it. But WHY DID SHE HAVE TO BE IN PAIN TO BEGIN WITH? And that’s just a dark loop that takes you nowhere good.
So as of now, six days after the worst day of my life… I can honestly say the only thing that makes me feel better is shared suffering. Knowing there are people out there who are just as shattered and heartbroken as I am. Because all I can do is look at the broken pieces of my heart and wonder how I will ever be able to put them back together again. Akeela was 13 years and 8 months old. I cannot remember a time when she wasn’t in my life. And I don’t know how to be a person without her. So now I live with every day being the saddest day of my life. No words will ever make it better.
They better be taking good care of my baby up there in wolf-dog heaven.
@tripawdakeela


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Pain Management Check-Up
Saturday June 06th 2020, 1:08 am
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June 5, 2020.

11.5 weeks post-amputation.

Today I learned that the majority of dogs have to be euthanized. Of all the dogs that have been in my life, I have never had to experience this.

My parents gave our first dog, Angel- an English Mastiff, to a rescue when we moved from California to Oregon. Our second dog, Stoli, was hit by a car before he reached his first birthday (thanks to my father). And our yellow lab, Sonny, died peacefully in his sleep as an old man under a walnut tree. My heart cannot fathom the idea that one day I am going to have to make the decision to end her life.

Akeela had her fourth visit with our Pain Management Specialist, Dr. Downing, today. I asked her how most dogs with cancer die. Regrettably, she informed me that most dogs have to be euthanized. The chance of her peacefully dying in her sleep is very unlikely. That said, she may not die from cancer. For a dog her age and breed, she may actually die from kidney failure. In all cases, it sounds like I will at least have time to prepare. And although their lifespan is never guaranteed, Dr. Downing is hopeful to believe that Akeela has quality life left in her. And that is all that I can ask for.

Although let’s be real … I tell myself every day that she has at least two years left.

We are upping Akeela’s Gabapentin intake slightly, to keep her blood levels from peaking and causing her to have episodes of discomfort between doses. She now takes 5,600 mg per day in addition to her daily dose of Amantadine, Carprofen, Proin, Yumove and Senilife. She takes a combination of medication 3xs a day and will for the rest of her little dog life. Fortunately, she rarely ever lets out her scream/yelps of pain anymore. You know, the high pitch, blood curdling sound that will haunt me until I die. I believe I’ve mentioned it before.

She has her fourth and final dose of chemotherapy next Wednesday. When we first started chemo, the Oncologist mentioned that there is another medication that we can start after her 4th round. Apparently it has been proven to slow down the growth of cancer cells. Some dogs have lived up to two years with a combination of this medication + chemotherapy. Although, as always, nothing is guaranteed with cancer. If we don’t move forward with the additional medication, then it will just be a waiting game. Metastasis in the lungs or no metastasis. Normally it’s just a matter of when. So if this drug has any chance of postponing the cancer that’s consuming her from the inside, then I am all-in.

She was reunited with her boyfriend last week for the first time since her surgery. It was underwhelmingly anticlimactic. We expected a grand reunion, but instead, they simply said hello with a quick nose-touch and then resumed with their regular activity of grass sniffing. Towards the end of the night, he did start licking around her incision and toe staples. It was actually quite endearing. There was no tug-of-war, leaping, zoomies, or body hurdling that evening. And I don’t know if there ever will again.

She isn’t the same dog that she was before surgery. There’s no doubt about that. We can barely walk around the block before she’s ready to pass out under a tree in the closest yard that she can find. I’ve seen lots of dogs go on hikes and ruff-house with their friends after amputation … but I just don’t think that’s going to be the case with Akeela. I think the next chapter (or hopefully chapters) of our lives will to be a bit slower than we anticipated. No more hiking – her all time favorite activity. No more runs through the neighborhood. No more playing like a rabid animal with her boyfriend.  And that’s just how life goes.

Despite all of this, I will still find ways to life her spirits. She only has a few years left so I am determined to make them her best. For starters, I moved into a new house last week, and she will be living with her boyfriend. We have a very lush green backyard with all the best smells (and also a slight rabbit infestation). I also recently purchased a lavish dog stroller from Chewy. She may not be able to walk to the park by our new house, but nothing will stop me from rolling her there! Stroller should arrive by next week, so I’ll be sure to inform ya’ll how it works for us.

And lastly – there’s a very important topic that I’ve been thinking a lot about. Our world has experienced some scary and unfortunate things over the past couple of months. Covid19, quarantine, murder hornets (wtf), and the Black Lives Matter/police brutality movement. I have always been a huge supporter of peaceful protests. I participated in my first one when I was 16 years old in front of the Courthouse in my hometown. I believe they are an incredibly important resource to use for strengthening human rights.

I would love to be a part of the protests that are happening all around me. I want to be there supporting my fellow activists. Because that is how you make change happen. Every day I hear stories about people being brutalized and jailed during these peaceful protests. Normally I would have no problem with taking that kinds of risk. But now I have someone else to consider before I make a decision like that.

Nobody loves Akeela as much as I do. And nobody is as in-tuned to her signals as I am. What if something were to happen to me? What if I was harmed/impaired, or even temporarily jailed? Who would ensure that Akeela’s medications are given to her 3xs a day? Who would wake up in the middle of the night to console her when she has an episode? Who would empty their bank account to ensure that she lives in a world of discomfort? Who would dedicate their life to ensuring that she is happy? Who would do any of these things without feeling resentment towards her? The answer is nobody. Nobody is capable of giving her the love and devotion that I give her. And nobody is as in-tune to recognizing her signs of pain and discomfort as I am.

So I guess I’ll sit this one out for now…. begrudgingly. And when my vet bills become more infrequent and less bankrupty (which thank the dog-gods they finally are), I will be able to donate to the organizations that need help most during these times of tragedy.

Because since Akeela’s surgery, my life is different now too.

Until next time – stay safe out there.

 



7.5 Weeks In
Saturday May 09th 2020, 9:53 pm
Filed under: Uncategorized  |  8 Comments

May 9th, 2020

I realize my last post left our situation sounding a little hopeless. I have reflected over the past week + and have come to some realizations.

Although Akeela has to be medicated every 4 hours and likely will be for the rest of her life, I am lucky that she is still alive. I feel fortunate that she can go 90% of the time without being in pain. Akeela now only yelps once a day – maybe once every other day. She also stopped wetting the bed. Both major wins in my book.

Yes, she isn’t living the maximum quality of life that I was hoping for – or expecting, based on what the vets told me pre-surgery …. but she is alive, and her suffering is now at a minimum. Unless the Dog Gods throw us another unexpected curve ball, I finally feel like we have a shot at a successful recovery.

Even to this day, it is discouraging to see the success stories of other dogs… the ones where dogs recover after 2 weeks. It was aggravating that every veterinary professional I spoke with assured me pre-surgery that she would have a seamless recovery. It was overwhelmingly frustrating when nobody could tell me why Akeela wasn’t recovering correctly – and was left in unbearable pain for 2 weeks straight.

You never really hear about the dogs who don’t recover, or who have a challenging time with it. And that’s why I started this blog. Our journey was completely different than what I ever imagined. I think it’s important for people to know that not all dogs recover the same way. And having an amputation done may cause unexpected complications on other parts of their body. But that doesn’t mean that there isn’t a solution. And it definitely doesn’t mean that your only option is euthanasia.

I admit .. I filled out the tripawds satisfaction survey a few weeks back and noted that if I had the choice of a do-over, I wouldn’t have proceeded with the operation. But sitting here at 7.5 weeks and knowing what I know now … and weighing all the considerations … I am glad I moved forward with the operation.

If we had not operated, we ran the risk of having a pathologic fracture in her arm at any time. And that would have created an emergency situation. So at least I can be at ease knowing that I did help prevent her from being in that unnecessary pain. Removing her arm amplified other issues that she had, and that I didn’t know about. But if I hadn’t moved forward with the elective surgery 7.5 weeks ago, our post-surgery recovery would have been just as dramatic and traumatizing, but she would have also had to experience the trauma of her leg shattering beforehand.

It took me a long time to come to terms with this, and I’ve had to hear it myself a half dozen times to actually believe it … but I did make the right choice by having Akeela’s leg removed.

I have had a couple people reach out to me this week and thank me for the blog that I’ve created for Akeela. It brings tears to my eyes knowing that our story is helping other tripawd-parents (or soon-to-be tripawd-parents). That is the entire reason I wanted to make our journey public. It sucks that Akeela had such a horrible recovery. I hadn’t read any stories of dogs who suffered like she did, so I thought that we were alone. But I am happy to know that our journey can at least be used as an example for others.

Having made our story public, I am now hearing from other families who DID have similar (though maybe not quite as traumatic) experiences as us. Why aren’t these complications more publicly known? I do truly believe there is a disconnect between the Surgeon/Oncologist perception of recovery vs what some dogs actually experience. I think that they should be able to provide you with resources and information to help through the process if your dog doesn’t experience a seamless recovery. Or even warn you about the potential recovery complications before the surgery. Do they just not hear about them? Though our Oncologist is absolutely stellar in so many aspects (specifically the Longmont office), we did not have the support we needed. I just feel so fortunate to have found the Tripawds Community, because without them – who knows where we would be.

So the best I can do is to continue updating our blog with Akeela’s story and hope that we can be a resource for dogs who are struggling like we did.

 



Six Weeks In
Thursday April 30th 2020, 7:18 pm
Filed under: Uncategorized  |  3 Comments

April 30th, 2020.

Yesterday was Akeela’s official 6 week amputation-aversary. One thing this experience has taught me is to always expect the unexpected. You never know what’s waiting for you around the corner….

Akeela had her 5th rehab session (laser therapy and acupuncture) and her second round of Carboplatin chemotherapy. The clinic I found has both of these services in one location, so it’s a convenient one stop shop for us. Between rehab and chemo, the Oncologist gave me a call. During rehab they found that an abscess between her toes on her back leg had exploded. Oh goody. This is the same foot that she has been incessantly chewing on for the past few weeks. I have had to keep a sock on her foot around the clock to prevent her from going to town on it. She’s chewed and eaten 2 of the socks, so we’re now down to 2 – thank goodness they come in 4 packs and we only need one.

So now they wonder…. did she pick at her foot so much that it formed an abscess? or was she picking at her foot because there was an abscess? Whose to say, really. So they cleaned it up for us and sent us off with antibiotics – another medication to add to her daily regiment.

About 4 days ago I noticed that Akeela had some wet spots on her bed. After examining her body and the position of moisture, I determined that she had peed the bed. She has never done this before. It was very peculiar, because it didn’t seem like she had even realized what had happened. She has now done this about 6 times – usually it happens late at night or early in the morning. Dr. Downing believes that this may be due to heavy sedation (she gets her largest dose of Gabapentin at night – 1200 mg). I have a follow up appointment with her tomorrow, so hopefully we can find a solution for this. I’ve currently lined all of her bedding with plastic bags and spare sheets. She absolutely hates baths, so I’ve resorted to wiping her body off with a wet rag and water/baking soda mixture. Just one more list of bizarre ailments to add to the list ….

At 2 am this morning I had the pleasure of waking up to the sounds of Akeela vomiting. I swear, nothing gets you out of bed faster! She had also peed the bed … not just a little pee like normal … the bed was soaked. So I took her out to potty, cleaned her up, swapped out her bedding, and gave her a Cerenia (anti nausea) tab. The vet said vomiting/diarrhea was a common side effect of chemotherapy. She didn’t show any symptoms the after her first treatment, so it took me by surprise this time.

A few hours later I woke up to the sounds of explosive poo in the hallway. What a morning. So round two of taking her potty, cleaning her up, swapping out bedding, and giving her a Metronidazole (anti diarrhea) pill. And naturally she couldn’t just aim for one rug..  she had to get it all over 3 different rugs throughout the house. And now that I’m siting here reflecting on the incident … I’m realizing that I forgot her poo is considered toxic after chemotherapy. I was definitely scrubbing the rug out with my hands and a sponge … so … hope I don’t die ….

Well back to the story: I gave her the evening round of medication at 8 pm and she didn’t throw up until 2 am, so I figured her body had digested it in that time. I didn’t want to give her more pain medicine, since she already shows signs of extreme sedation at night. Well. Apparently I was wrong. She had returned back to her panting/pacing/whining/yelping routine. It lasted from around 9 am until 11 am. And of course now that she is nauseous, she is resistant to taking any kinds of medication – even when they are disguised in delicious Greenies pill pockets. So that leaves me to open her wolf trap and shove about 6 pills down her throat with my hand. Isn’t recovery fun?

I guess after all things considered … at least her episode of diarrhea and vomiting is considered a ‘normal’ side effect of chemotherapy? I could definitely live without the exploding abscess, screams of pain, and bed wetting though. About time the Doggy Gods cut us a break.

Maintaining Akeela’s pain medication schedule is quite the feat in itself. She is currently taking medication 4 different times throughout the day. They are spaced around 4-5 hour intervals. If I give them to her too close to a meal or an hour too late, it will result in about 2-3 hours of agony for her. This completely varies depending on the dog, so it’s been a learning experience trying to figure out the exact schedule for her. Dr. Downing said that the fact that she still has those yelping/panting/pacing episodes means that we are not quite at the Gabapentin dosage that we need to be at. I have been incredibly fortunate to work at home throughout the Coronavirus, so I’m able to clock out here and there and console her if she has these episodes. I would not be able to do that if I was at the office. So I do feel grateful that I can at least be at home with her while we work out her proper medication dosage.  Eventually we will hopefully get to the point where her medication can be spaced further apart, but as of now, I cannot do anything that would keep me away from her for longer than 4 hours. It has been a big responsibility, but manageable for me given the current circumstances.

She has come a long way from where she was a week ago, but she is still not having the quality of life that I had expected post-surgery. I will do everything I can to keep fighting for her, but it is painful to see her in so much distress. Our road to recovery has just been a continuous number of set backs. I can’t wait for the day that she is back to her normal (but now 3 legged) self and I can look back and think “Wow, that was miserable, but at least we made it through.”

 



Five Weeks Post Surgery
Wednesday April 22nd 2020, 4:45 pm
Filed under: Uncategorized  |  7 Comments

April 22, 2020.

 

Ohhhh where to begin … I suppose where I left off last ….

On April 15th I took Akeela in for her 2 week post chemo blood work test. I mentioned to them how she had still been incessantly pacing around at night panting heavily. She would also continue to let out little (but sometimes large) yelps throughout the day. After her exam, the doctors had reason to believe that the cancer had metastasized to her spine. This only occurs in about 7% of dogs and after diagnosis they usually only live around 3 months. I decided to move forward with the CT scan, since that would completely change treatment options. My best friend – who also happens to be the pawrent of Akeelas boyfriend- drove out and cried in the parking lot with me while I awaited the news. After what felt like an *eternity* the doctor called me back with good news! I literally cried tears of joy 😭 The cancer had not spread to her spine! They did note that she is still very inflamed, which is unusual that far after surgery (4 weeks). They also noticed that she has a disk that is just barely bulging to the side, but she does not act in pain when this area of her body is touched, so they didn’t think that is what was causing her most discomfort. They cut back on all the new meds we just started, began a 2 day cleanse, and then started on a steroid known as Prednisone (to help with the inflamation). I felt like the doggy gods were truly looking out for us that day 🙌 The pictures below are the messages that the nurses sent me before and after her CT scan. If you are ever going through this with your dog and live in Colorado, I highly recommend Aspen Meadow Veterinary Specialists. They genuinely care about Akeela and our overall wellbeing.

I felt incredibly relieved to hear that she did not have cancer spreading through her spine, but at the end of the day, the Oncologists couldn’t really tell me exactly why she was still in so much pain. Which is why I ended up at the Boulder Oncologists office the very next day – Alpenglow. Alpenglow is the ‘sister clinic’ to Aspen Meadow. Because of Covid 19, the Doctors are not working their regular shifts, which is why I ended up at Alpenglow.

I took Akeela in around noon the next day, because she was absolutely inconsolable. The anesthesia from the CT scan the day before was completely out of her system. She was pacing, panting, drooling, whining, yelping, and I could not get her to settle down no matter what I tried. This was even more devastating, because for the first time in a week she had actually slept through the night. How was it possible for us to keep doing these 180 degree turns with her health?? I was hesitant to bring her back to this clinic after my 2 am visit I had with them the weekend before. There was a snafu with her medication (they sent it to Walgreens) and it took me almost 24 hours to get it filled. The Oncologist on site never called me back, so I ended up calling the Longmont office and pleading them to get it filled. Coincidentally one of their Oncologists happened to show up that day, even though she was scheduled to have it off. They had my prescription filled in less than 30 minutes. I never heard back from the Boulder office.

Well, the Doctor at the Boulder location gave me a call after her exam (due to Covid19 nobody is actually allowed inside the building). She said that even though my regular Oncologist could not find anything in her CT scan, that she still had reason to believe that Akeela had a metastasis in her spine – um what? I had literally just spent an entire afternoon crying in my car and spent a whopping $1300 to hear that she DIDN’T have cancer in her spine … now this Doctor was telling me (very casually) that she did? No no no. That can’t be right. She then proceeded to tell me that they were going to put a Fetanyl patch on her back. It could take 24 hours to kick in, but would last up to 3 days.  If this didn’t work for pain, then her next recommendation was to leave Akeela at their office for 12-24 hours while they pumped her with heavy pain drugs. This would supposedly “break the pain cycle.” Hmmmm. And before the conversation was over, she (once again very casually) mentioned that I may want to start considering HUMANE EUTHANASIA. I decided that day that I would never be returning to the Boulder office. In fact, I would not go to them if they had the last Oncologist in the state of Colorado.

Well …. as I’m sure you could all guess … the Fentanyl did absolutely nothing. By this point I had racked up a couple thousand dollars in vet bills over the past couple of weeks. I didn’t want to bring her back to the Oncologists, because after all these visits nobody could tell me WHY she was in pain. During the day she seemed like her normal happy self – sleeping, jumping onto the patio, bringing me her dead babies (what we call her destroyed stuffed animals), wagging her tail, and so on. At night she turned into an absolute demon. So I did what I could – booked her a ton of Acupuncture appointments and stayed up all hours of the night consoling her. On Sunday night I had finally had enough (was about 9 days of no sleep at this point) and tried the ‘tough love’ technique. I kicked her out of my bedroom at about 4 am. Welp, I sure learned my lesson. Although I did get about 3 hours of poor quality sleep, she on the other hand, decided that her foot was a tasty treat and turned it into a bloody mess. I just couldn’t catch a break.

Fortunately we had our follow up acupuncture visit on Monday at the same place that she gets her chemotherapy. They removed her (useless) Fentanyl patch and cleaned up her foot. They also prescribed a sedative/anti anxiety medication known as Trazadone. I had to carry her up the stairs because she was SO tired after our visit. I thought to myself – “Yes, this is it. We are finally going to turn this around.” Well, as I’m sure you know my story goes so far … it didn’t.

I had spoken with the wonderful founders at Tripawds Community on their chat portal the day before. They recommended that I visit Dr. Downing in Windsor – which is about an hour north of my location. She specialized in pain management and had extensive experience with animals suffering through ostesarcoma. I later found out that she herself went through this with a Great Dane a couple years back.

Our appointment was yesterday morning – Tuesday the 21st. I had gotten about 2 hours of sleep the night before. It had now been about 11 days without a full nights sleep. I’m not going to lie, it probably was not safe for me to drive to her appointment. In aviation we have an “IMSAFE” checklist that we go through before deciding to take flight. We have to determine if we were being affected by illness, medication, stress, alcohol, fatigue, or emotion. If we mentally noted ‘yes’ to any of those, then it’s not safe to operate an airplane. I definitely did not pass the IMSAFE checklist. I was delusional, exhausted, spacey, and was having very dark thoughts about Akeela. At one point in the night I even found myself being spiteful of her. When I recognized that thought I immediately began sobbing. It wasn’t her fault and I knew that. Your mind goes to some dark places when you don’t sleep for almost two weeks ….

Well, I’m writing this post now so you know I made it safely to our appointment and back home. I wanted to wait to post until at least the day after our appointment, because we had experienced so many dramatic ups and downs over the past two weeks. When I left Dr. Downings office I felt a different kind of hopeful than I had with the oncologists all those times before.

When we arrived, I called the front desk to let them know that we had arrived, as this was common practice for all other clinics. The receptionists sounded a little confused and told me that I was welcome to come in, so long as I was wearing a mask. Wow! This was the first time  that I would actually get to be present for her exam! I was thrilled.

Dr. Downings office is what’s known as a “Fear Free” clinic. They encourage pet parents to come in with their animals, since this is what’s most soothing for them. They also play reggae music softly in the background, because apparently studies have proven that dogs enjoy reggae music. Lastly, they had a humidifier that released pheromones into the air, which also aids to calming dogs down. Their entire office is set up in a way to make dogs as comfortable as they possibly can be (given the circumstances).

After Akeela’s exam with Dr. Downing I FINALLY had answers. She had read through Akeela’s expansive history before our appointment, so the exam was fairly quick. It felt like she knew what the problem was even before we arrived. The physical examination just confirmed her theories.

So bad news first: the bulging disk in her back is likely adding to her pain, it just may not be directly in that specific area, her back muscles are still incredibly sore and spasmy from over-compensating the missing limb, and her spine has arthritis. ARTHRITIS. Of course, this isn’t really something that can be proven, but Dr. Downing said that for being a large dog and at her age (13) it would be almost impossible for her to not have arthritis. THAT MAKES SENSE. She said that Akeela was experiencing back pain and muscle soreness before the surgery as well. Removing her limb just drew attention to that area and amplified the problems that were already there. That is a much better explanation of her back pain than what the Boulder Oncologists said – quick reminder: cancer metastasizing in her spine, even though nothing could be found in the CT scan.

She is also experiencing nerve pain from the amputation, which will never go away. This is currently the main cause for her agony and is what’s causing her to make those god awful, high pitch blood, curdling ear piercing yelps that will haunt me for the rest of my life. Dr. Downing also explained that her nerve pain is also what’s causing her infatuation with her foot, as it now feels different than it did before. Her new gait is also putting pressure on her outside toe, which is causing her toenail to rub and giving her more reason to pick at it. So at least I have an explanation for why she is suddenly so obsessed with chewing on her back left foot in the middle of the night.

Dr. Downing also believes that Akeela is experiencing Cognitive Disfunction Syndrome, which is likely causing her crazed behavior at night. There usually are more symptoms than just one, but not in all cases. A big event (such as the amputation of an arm) can trigger this in older dogs.

The Doctor said she is about 8/10 on a pain scale. And that’s with her daily dose of 300 mg Gabapentin 5xs a day – not to mention the mix of random other medications we’ve tried over the past two weeks.

Now, finally, the good news: Dr. Downing thinks that we should be able to get her pain under control over the next few weeks. We are cutting out some of her previous (unhelpful) medication and adding some new ones. 300 mg Gabapentin 5xs a day is now becoming 600 mgs 4xs a day. I had read on the tripawds page and had heard from instagram-buddies that many dogs were on larger dosings of Gabapentin. I asked my Oncologist about this at our last appointment and she said for a dog her size, they would not recommend increasing her dose. Well – we are now going from 1500 mg per day to 3000 mg. And she hasn’t. yelped. once. since our appointment.

We also added Yumove hip and joint supplement (to replace Dasaquin) and Senilife to aid with her anti-inflamation medication that start in 10 days (having to phase out the steroid). We went over a LOT of information, but she explained how each one of these new supplements is actually better for dogs that are going through chemotherapy and will compliment what they do.

We are also adding Melatonin to her nightly routine and she is sporting a fancy pheromone collar to help soothe her through the night. It’s tough to say if the collar is helping at all. They last up to four weeks and are only about $20, so not the worst investment if it actually has an effect on her. I purchased her Melatonin at my local grocery store. The most they manufacture them in are 10 mg – but her dose is set at 50. So she gets a LOT of pills at night.

Because she is going through chemotherapy, Dr. Downing recommended avoiding raw foods since she has a weakened immune system (literally never even crossed my mind). She is now eating canned Science Hill puppy food- and freaking loves it. She has been a picky eater for the entire 13 years we’ve been together. I never considered feeding her puppy food. Learn something new every day (or lots of somethings in my case).

Dr. Downing also recommended that we continue with acupuncture. We have 2 visits a week booked for the next two weeks. I am hoping that this will at least help ease her back pain. The clinic also does laser therapy, which should help with her incision that’s had a difficult time healing.

I will note that I was initially surprised when she recommended that I stop supplementing Akeela with CBD oil. Everyone always recommends CBD! Well, it turns out that only a few CBD companies in the US actually have studies where they’ve tested on dogs with Osteosarcoma. Most published studies (which are minimal) on CBD were done on dogs with arthritis. Because we don’t actually know how CBD will affect dogs with Osteosarcoma specially, she recommended we hold off on that.

We have a follow up appointment with Dr. Downing in 10 days. She will do a pain exam to see how far we’ve come along and will start Akeela on a new anti-inflamatory (that doesn’t interfere with chemotherapy) at that time. It turns out that steroids usually aren’t recommended to be used in combination with chemotherapy. And a side note: after our appointment I looked online at all the new supplements and was able to find them for about 30-40% cheaper than what I paid at the office. If they prove to work for her, then I’ll be ordering refills from the great wide web. 1800 Pet Meds had most of them – if anyone else has recommendations, I’m all ears!

Also an unrelated bit of good news that we heard – Akeela is not actually blind! Every doctor we’ve seen over the past 6 years have mentioned that she has severe cataracts. I remember the first time I heard the news from a vet, I started bawling my eyes out … ohhh if only I knew the cruelty that the world actually had in store for us. I would have saved my tears. Dr. Downing said she actually has something known as ‘lenticular sclerosis.’ It essentially just causes a hazy hue in older dogs eyes and does absolutely nothing to affect their vision. So I consider that a little win for us.

I was worried that all this medication may hinder her living the best life – or more that I was concerned that her life would be shortened because she does have chronic pain from amputation. Dr. Downing assured me that this was not the case, and having a pain treatment plan in place would help extend the life that she has left with me. She also said that once Akeela’s pain is managed (she has hope that we can get to a 1/10) she should be able to go on hikes again and run around with her boyfriend. This made me cry, because for the past few weeks I’ve just been thinking about how she’ll never be able to rough house like she used to. You would NEVER guess her age if you watched her play with other dogs. She was always so agile and so freaking fast – leaping over other dogs and running circles around them while they tried to catch her. It was relieving to hear that she can still have a fulfilling play-filled life.

I was supposed to take my commercial pilots license checkride last month, but due to Covid19 and my new financial obligations (otherwise known as vet bills)- that has all been put on hold. After I got my license, my plan was to get a charter-flight job somewhere tropical and touristy so that I could build hours. Of course that would mean moving and having a job where I would be traveling most of the time. If Akeela only has a year left of her life, then I want to be with her for it. So yesterday I signed a year long lease on a new house with my best friend (and Akeela’s boyfriend) that has a obscenely large yard — and is almost entirely carpet! I plan to give her the best last year that any dog can have.

So there’s a rundown (in less sciency terms) of our visit. It was a LOT of information to process, but it all makes sense and seems like we finally have a glimmer of light to follow 💛 I had reached a standstill with our oncologist, as they had exhausted their pain treatment options. I am still in shock that the Boulder office recommended euthanasia.

I slept through the entire night for the first time in 11 days last night. Akeela only changed positions ONE time – which I only know because when I fell asleep she was facing one direction and when I woke up she was turned the opposite way. And she hasn’t let out a yelp in over 27 hours. Experience has taught me that I shouldn’t get too exited or hopeful, because everything can change within the next hour … but for now, we’re good. I am at ease knowing that we have Dr. Downing as a resource now.

I cannot begin to describe how thankful I am for Dr. Downing and for Tripawds for recommending her to me. I am going to write her a GLOWING review later this afternoon. As I type this out, I am tearing up again, because she truly was a LIFE SAVER. It has been a very emotional couple of weeks, and for the first time I actually feel like we are going in the right direction.