The Last Lap

Sunday, May 28, 2006

We were gone yesterday (Saturday) from 9 a.m. to midnight, moving Scott to Nebraska, setting up his new apartment and building furniture. I gave Jasmine her AM pills (doxy, cytoxan and tramadol) and "grandma" came by a couple of times to let them out and make sure the house was still intact. We got home at midnight, which means Jasmine didn't have her PM pills (Deramaxx, doxy & tramadol) until then. She was limping, but spry and happy and the perkiest I've seen her act in weeks. I gave her the Deramaxx and doxy but not the tramadol. We've been giving her the tramadol at night, too, because she has been limping so badly. We used to just do it in the AM, and then if it makes her dopey, she can sleep the afternoon away while we are at work, and then the Deramaxx will take her through the night and next morning. Now, I'm wondering if the tramadol is making her more dopey than I originally thought.

I didn't give her a tramadol tonight, and she seems fine, just limping badly. Poor dog has almost no strength in her hind legs, so her front legs are taking the bulk of her weight, but her arthritis is bad in those joints.

Dr Hillers did email me back, and was going to think on what to do next with the wonder-mutt. She had her boards today, and then moves to Arizona (Sandy--watch for her, I'm not sure where in AZ), so her life is about as nuts as mine.

Jasmine's skin mets look about the same, maybe a bit bigger. With lung mets and skin mets, who knows what all else is going on inside. But, she is proving to be as tough as I thought she was.

I'm not sure how the dogs are going to handle us living separately for who knows how long. I'm thinking of it as a long series of week- long business trips. The apartment building has a "no pets" rule, so either Scott will have to come down here to see them, or I'll take them up there and meet somewhere else.

Thursday, June 1, 2006

I was just looking at the files, seeing if I can find any clue about "when is it time." I reread Jogger's story. I found the HHHHHMM scale (hurt, hunger, hydration, hygiene, happiness, mobility, more good days than bad). None of it really helped.

She was having such a hard time walking this morning, but then the silly dog decides it's time to play, and has a two minute sit and spin session with Levi. While I was home at lunch, she was limping very badly from her front legs (probably from her play session), and the back legs were just as lame. She can walk, they just give out on her at inopportune times. She also has more skin mets--I think we're up to five active ones. Levi keeps sniffing her nose, which either means the local recurrence tumor is worse, or her lung mets are worse. Part of me wants to take her to CSU to find out exactly what is going on, but then what? Will that change what we are doing? No. I just have to accept that the fight is over.

I found a quality of life scale from Oncolink: http://www.oncolink.com/types/article.cfm?c=22&s=69&ss=550&id=6005

  • alertness/mental status -- very good
  • appetite -- adequate
  • weight/body condition -- very little muscle tone in hind legs, front legs arthritic
  • activity/exercise tolerance -- very little tolerance ; reluctant to get off the couch without a massage and assistance ; hard to do two stairs ; still plays a bit
  • elimination -- ok for now, but I can foresee problems because of the rear leg lameness

I just wish she would give me more definite signs. Lameness and no playing. Obvious pain. Seizures. Trouble breathing. Difficulty in elimination. But, no, the tough old dog is holding her own against this da$n disease.

Scott started his new job in Nebraska today, and he's got a boatload of changes he wants to make. I told him to go slow--they haven't changed the way they do things in 20 years, it will take them time to catch up to the 20th century, and then move them into the 21st.

At my library, they loaded eight 48 foot semi trailers with books, map/microfiche/microfilm cabinets and various other furniture items on Friday and Tuesday. We officially closed today, not to reopen to the public until August 1st. It is pretty bare around here, and quite a mess. The Wyoming State Library has been in this building since 1937 (it was built for the WSL and the supreme court), and you can imagine almost 70 years worth of stuff accumulated in the nooks and crannies. It's like moving your grandparents. The new shelving is supposed to be installed beginning Monday, which means we need to start shelving the books from those 8 semi trailers starting then. We hope to have it done in 6 weeks, so the offices can move into the new space in mid-July. I am constantly tired, and I have little patience. I'll load more photos into Flickr tonight so y'all can see our progress.


Jasmine wearing her new button. June 2, 2006

Saturday, June 3, 2006

It was bath day at our house, too. However, as I gave Jasmine a bath, trying to rub her with one hand, and rinse her off with the other, I had to prop her up against my legs to keep her from collapsing. It may just be her last bath. She's now wearing a blue bandana with the "leave me alone, I'm living" button on it.

Scott came home from being gone all week, and the dogs were all "hey, glad to see you" but not ecstatic like I thought they'd be. It is quite hot for here. Jasmine did manage to get up for him, and enjoyed a hip rub. He noticed how bad she's gotten in the five days he's been gone. Each day is worse. She still has a glint to her eyes, and she eats and drinks and loves those cheesey-pills, but the skin mets are worse. We just passed the 22 month post-dx mark.

Wednesday, June 7, 2006

I got an email from Dr Hillers last night. She's at CSU until July 15th. She worries about her little superstar dog. I updated her on how Jasmine is doing. She thinks it is weird she has so many skin mets (last count was 5, but I've stopped counting), but then, we all know what a special dog Jasmine is.

I've stopped the MP, so she's on Deramaxx and tramadol. We might switch her to Piroxicam in addition to the tramadol. She hasn't gotten back to me yet about where to get the new drug. I took the pack out for a walk this morning. Jasmine did the quicky short loop-- up three houses to the alley, and then down the alley. No steps. No steep slopes. It was more of a sniff and stumble, but she seemed to enjoy herself. She just walks straight through weeds and bushes. It is so hard seeing her have a hard time getting around. That back right leg gives out on her frequently. I'm not sure if the Piroxicam will help with the stumbling, but it should help with the front leg soreness. Or, we can up her tramadol, or put her on oral morphine. Levi and Nixie enjoyed their walk. The three of us do the about a mile around the "big block." It was warm, but not too bad. I'm sure they are all flaked out in front of fans at home.

She seems to be having more problems with those back legs each day. It is almost like she can't feel or control where they go. But, I picked one leg up, and she was definitely putting weight on it. Same with the other. But, no matter which leg I picked up, she would collapse. She also collapses whenever she does a tight turn or goes down stairs. Does that sound like a disc problem? Arthritis? Mets? Or, does it really matter at this point? Sorry, I'm having a hard time transistioning from care-giver to hospice- provider.

She is also following me around a lot this evening, with this intense look in her face. I just gave her a Deramaxx and a Tramadol with dinner tonight, and hopefully that will take care of what pain she may be in. We're switching her to Piroxicam, as soon as I find someone in the area that carries it.

I just tested for knuckling under--I had to support her--and she'll right the foot, slowly. After it is set down, she'll pause, then she corrects it. Levi, on the other hand--my control subject--wouldn't even let me set his feet down on the top. So, it appears that the signal is getting from the feet to the brain, just slowly. Probably FARPs. Or, mets.

Thursday, June 8, 2006

Dr Hillers is concerned, and may put her on prednisone. She's going to think on it and call me. I don't know, maybe I just need to take her to the local vet to verify what it is. But then, I'm not sure he'd recognize it for what it was, and I really can't afford the money or the time off from work to take her to CSU.

I suspect mets. She seems to have a bump on her lumbar vertebrae, just after the last rib (middle of back). I do regularly rub her legs, hips, and back, and she seems to enjoy it. Or, at least it isn't painful. But then, she is a very stoic dog. I tried checking her back legs for lumps, and didn't feel anything. But, when I touched her left hock, her leg flexed--in pain? I don't know. She seems to have a bit of a lump there. Met? Arthritis?

I haven't contacted the Argus Institute, yet, but I did look at their website yesterday. I may email them tomorrow for assistance.

Dr Hillers called and based on what I described to her yesterday (collapsing, delayed corection to knuckling under, feet crossing), we're skipping the Piroxicam and going straight to prednisone. I should be able to pick it up from my vet today, but he's out on a family emergency, so the part time vet should have it. 40 mg once a day in the morning, with food, I assume. She's going off the Deramaxx today, for three days before we start the prednisone.

And, on a bit of a morbid note, Dr Hillers says that CSU will do necropsies for free. I've read too many retrospective studies in which the fate of most of the dogs is unknown. Did they die of cancer? Or, something else? So, if I can give anyone in the future more of a fighting chance against this disease, wonderful. It is the least we can do.


The two luminarias I decorated for our Relay For Life. Left, the front side for one for Jasmine and one for all BoneCancerDogs. Right, the back sides.
June 7, 2006

Saturday, June 10, 2006

Morning

Jasmine was doing great yesterday. I took her off the Deramaxx on Thursday, so it was day two without an NSAID. Her hind end would still collapse, but her front end seemed to work fine. Then, Scott came home from Nebraska about 9 p.m., and she was all wiggly (yeah!) and perky and glad to see him. But, by 10 p.m., she could hardly put any weight on her right front leg, and her left front leg wasn't much better. Which left her half a leg to get around on.

I got out Nixie's sling from her knee surgery days. It is a "large" which is too large for my wasp-waisted Dane, and only someone who was 6' tall or taller could use the handles 'cuz she is so tall. But, it worked on Jasmine. It covered her entire torso, but that is what I needed. I half carried, half dragged her outside, supporting most of her weight, but she didn't want to do any business, so I half-carried, half-dragged her back inside.

About 3 a.m., she needed to go out, and she was even worse. Mind you, I've been giving her tramadol every 8 hours since Tuesday, but that didn't seem to be working. I ended up picking her up and carrying her outside to her favorite spot in the yard. She did manage to do an abreviated version of her poop ritual--pace back and forth until she found THE perfect spot. She had a nice sized, colored and shaped BM. But then I had to carry her back into the house, and then through the kitchen to the living room, where she drank a bunch. The saddest thing about this whole episode is that she didn't once squirm or wriggle when I picked her up. Usually, she'll wriggle whenever I pick her up to put her on or off the bed, in sort of a "MOM, I'm a big girl, I can do this by myself" kind of way. But she didn't do that. It is so sad. My husband slept through the whole ordeal.

At 6 a.m. she was panting hard, and I knew it was time to give her tramadol. However, it was only 65 in the bedroom, so I knew her panting was from pain and not from being hot. I dug out the morphine from her surgery, and gave her one. At 9 a.m., she was still breathing hard and panting a bit. I took the pups for a walk- -get them out of her hair and give them a bit of attention. Came back, Jasmine and Scott were still on the bed, so I lifted her off the bed, but she wouldn't/couldn't walk to the living room, so I carried her there. She wouldn't drink, so I carried her outside. She layed out there a bit, managed to go pee (front left leg back to support her), and layed around some more. Carried her back in. Carrying her around the pups is hard, since Jasmine is now higher than Nixie, so Nixie wants to sniff and she raises up to do so. Jasmine did manage to get herself to the bedroom and she's now laying on her dog bed. She isn't panting, so maybe the morphine is working.

I'll email Dr Hillers and see if she's online and can suggest something. If not, I'll call CSU emergency and see what else we can do--start the prednisone a day early, keep her on the morphine, take her down there. I don't know.


Afternoon

We decided to release Jasmine from her earthly pains today.

Her grandma and auntie (Scott's mom and sister) came over to say good-bye. It was like the living wake in Tuesdays with Morrie. More happy memories, and not so much sadness.

We then drove her and our other two dogs to CSU. Dr Hillers called from Denver to find out what was happening. She understood our decision. It took a while once we got there--the doctor on call was treating a dog that was hit by a car. CSU has very nice "comfort" room, with dog and child toys, books, a tv, and nice furniture. Much nicer than the rather cold and sterile rooms at our local vet's office. We discussed options--yes, we want a necropsy, yes, we want her privately cremated, and yes, we want a paw print. Levi and Nixie paced and sniffed and panted, and drank a ton of water. The vet student on call took Jassy back to get the IV catheter in, and then brought her back. She said that little dog was walking fine. I mentioned that I'm sure it was towards an outside door--it was. I'm also sure she was so full of adrenaline that she could've gone a while, but then she'd crash really hard. Once the doctor got there (I've forgotten everyone's names), it was a very fast process. Jasmine was gone quickly, painlessly, at 3:17 p.m. MDT. The pups sniffed her, but seemed clueless. Now, they are moping around, missing their little dog.

I'd like to thank everyone here for their prayers and well wishes. She put up a damn good fight, and I don't regret a treatment we tried or didn't try.

Tuesday, June 13, 2006

Dr. Hillers emailed me with the preliminary report:

1. Lungs, kidneys, heart, skin, and ribs: Multicentric, metastatic osteosarcoma.

2. Mass, liver: Hepatoma (a hepatoma is a benign liver mass).

My first reaction was, OMG, how on earth did she live with all that growing in her? Wow, she was stronger than I suspected. I think this cements her wonder-mutt status.

Tuesday, August 8, 2006

I've only glanced through the final report, but, man! that dog had some moxie! I knew from the preliminary report where it had spread (lungs, skin, heart, kidneys, ribs), but not how much. Over 100 lung mets. 5 to 10 heart mets. 5 to 10 kidney mets. About four rib mets. Various skin mets. All mets range in size from 2 mm to 6 cm. An 8 cm liver tumor (not OSA). The histopathology report is over my head, but I get the gist of the report. Wow. It also shows how fast this disease can move. By the end of March, when we met Cindy and Leslie and Patti, she had three lung mets. By the end of April, she started to develop skin mets. By the end of May, she was having difficulty walking.

I am glad on so many levels that we did the necropsy. We found out how bad it got for her, and I don't feel guilty that we could've tried just one more thing. We ended her suffering before it got worse. Another reason I'm glad is because Dr Hillers, her oncologist, also got closure. She finished up the report after her residency had ended. The vet students were able to hone their skills. And, most importantly, she is now in the database, for any future retrospective studies. That way, she can help out someone else's pup, and maybe they won't have to go through this.

Here is the final necropsy report. You go girl!