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Pain Management Check-Up
Saturday June 06th 2020, 1:08 am
Filed under: Uncategorized

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.

 





     
9 Comments so far

Hi! I’ve been following Akeela’s adventures on Instagram and it seems like she really loves the new house! Do you know the name of the drug that your oncologist might recommend after chemo? I’m asking because there has been a discussion on the forums about Auranofin, which limited studies have shown might slow/prevent the growth of lung mets. Griffin’s oncologist had not heard of using that drug before, but is willing to prescribe it if I want, and so I’m trying to gather as much information as I can from other Tripawd parents who might go that route. I can’t wait to see Akeela in her fancy new stroller. I hope you both are staying safe and doing well! ~ Stacy

   Stacy on 06.06.20 @ 1:32 am    Reply

    Hello! I actually cannot remember the name of the follow-up medication. My Oncologist briefly discussed it the day we met for Akeela’s first round of chemotherapy. I have Akeela’s last chemo appointment this Wednesday, so I plan on asking her all about it then. Akeela is on several different types of medication, so it’s important that I know all the details and make sure it won’t interfere or cause complications with what she’s already taking. I’ll let you know what I find out!

    And yes, Akeela takes 5600 mg of Gabapentin every day just to keep her pain under control. I originally had 300 mg tabs from the Oncologist, but our Pain Management Specialist moved us up to 600 mg tablets and now she is on 800 mg ones. Our Oncologist had told me that 300 mg 2x’s a day for a dog her size is more than enough … but clearly that wasn’t the case! It was definitely an experimental process, just because of the sedative nature of Gabapentin. We slowly built up on her tolerance, so she wasn’t just zonked out all the time. The 2400 mg dose I give her at night still makes her sleepy, but I also pair it with 50 mg of Melatonin – so she actually does sleep through the night (and let’s her poor mom get some sleep too). Melatonin only comes in 10 mg doses though haha so with all the meds combined, I do sometimes give her up to 11 pills at a time. Greenies Pill Pockets have worked wonders!

       akeelaisthecutest on 06.06.20 @ 3:45 pm    Reply

PS – Did you really mean 5,600mg of Gabapentin each day? Does that translate to dozens of pills each day for just that med? How do you get Akeela to take them all?

   Stacy on 06.06.20 @ 1:40 am    Reply

We just started on Auranofin last week. Three weeks post amputation. First chemo two weeks ago. Three year old female Labrador.
https://www.caninecancer.org.au/Osteostudyflyer-2.pdf

   Leanne on 06.06.20 @ 11:27 pm    Reply

    Thanks for sending that! I have heard of Auranofin a couple times now, so I wonder if that is the medication that my Oncologist recommended too.

       akeelaisthecutest on 06.07.20 @ 10:53 pm    Reply

I always love finding out how you two are doing. I also see the IG photos and I love getting the backstory on all that’s been going on. There’s so much that I can relate to in your experience of coping with life on 3 and cancer.

Knowing Dr. Downing I can totally hear her telling you about the end-of-life scenarios. She’s pragmatic with a heart. It’s tough to accept that we will likely have to give the go-ahead to set our furkid free, but by knowing and preparing for this, you have the ability to allow her transition over on your and her terms, not the cancer’s.

Just remember, don’t grieve while Akeela is still here. It’s the only way that cancer wins. Live each day as she and her boyfriend do. They just do what they love the most, and to heck with yesterday or tomorrow, neither one exists.

Thanks for sharing all the details and opening your heart. It’s an honor to be along for the ride.

   jerry on 06.07.20 @ 2:04 am    Reply

Oh one more thing I wanted to add: I remember feeling the loss of no longer being able to go on epic backpacking trips with our Jerry. Had no idea what our life would look like afterward, but things turned out amazing and we found new ways to have adventures with Jerry, other than those long hikes. With the invention of doggie strollers it’s easier than ever, I wish that they had been around when he was with us.

What I eventually came to accept was that while our long-distance hiking days and walks around the neighborhood came to an end with him, it was no different than had we been caring for him as a very old senior dog with four legs. Either way, it was a gift to have him with us so we just went with the flow and had a ball.

   jerry on 06.07.20 @ 2:08 am    Reply

Oh I also forgot to say that I understand your feelings about not being able to protest. It’s a tough call, but makes sense since you are Akeela’s only caregiver. Many people who want to protest are in your shoes, and there are many things you can do if you cannot be there. Get involved with a local civil rights group and ask how you can support them from home, reach out over social media, learn more about the issues and know that you are making a difference by doing so. xoxo

   jerry on 06.07.20 @ 12:05 pm    Reply

    Thank you for your reply 🙂 It’s definitely been difficult to see the changes that Akeela has been through since surgery. I try not to dwell on it, but it’s very challenging sometimes. I do feel very fortunate to get to spend all this time with her. I just want to do as much as I can to ensure that she is living a happy life too. I don’t know if dogs are capable of “missing” things, per say – like a hike up Mt. Sanitas. But if we can’t do excursions like that, then I want to be able to find other things that will cause her to feel a similar amount of happiness.

    Cancer is the WORST.

    Reaching out to local groups is a great idea! I started researching different organizations this weekend and made a few donations yesterday. Whatever I can do to help from home!

       akeelaisthecutest on 06.07.20 @ 11:04 pm    Reply


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