Author: dsimas

She was very impressed with how Raven looked considering her review of his case and the ER and ultrasound reports 6 weeks ago. 🙂

He has taken another turn for the better yesterday. We have a theory that we think makes sense:

He was doing GREAT last Friday, his bloodwork was normal and we removed the Baytril (he is still on Amoxi antibiotic) as it’s so expensive. His belly distended and he felt worse over the weekend. I put him back on as a last ditch effort on Wednesday and he was better by yesterday (Thurs). So, she thinks that the infection in the liver was never quite kicked, and quickly came back. That’s all.

Regarding the corticorsteroid treatment we’ve had him on (dex), he would always worsen on the 7th day and need another injection. She said that she thinks that is the withdrawal, not his need for it due to the cancer. I’ve been weaning him over the last 1-1/2 weeks wanting to reduce his reliance on it, and he’d gotten so bad last weekend I thought that may be why. She said no, the timing was just a coincidence that I had stopped the antibiotic last weekend, and that I am doing the right thing weaning him off the dex. Not only will it cause weakness (which he has been becoming very weak) it also is immunosuppressive, so that may be why the infection wasn’t quite killed.

SO, I am not giving him any more steroids, yay! He feels great today, back to normal, past the withdrawals, got the infection back under control. WHEW. The last few nights he was having the dreaded night pants and was restless…but last night he slept quiet and soundly again. 🙂

She confirmed that he does have lung mets in the xrays from 6 weeks ago (vets all had differing opinions on that). She would like a new chest xray, which we are doing tomorrow. If the lung mets have progressed, there’s nothing we can really do. But if they haven’t, then she said he’s definitely a candidate for biopsy and treatment of this liver mass, rather than just doing nothing.

Either way whatever the xray shows tomorrow…I’m just happy he feels better, I have some answers and clarity on the drugs…these were my two main prayers!

Here’s Raven doing his happy upside down roll on the rug:

Please bear with me if you are not Christian, the quote below is so wonderful…

I have this book of daily encouraging words called Jesus Calling by Sarah Young. This morning, I have quoted below what it said, it is always written as if spoken by Jesus. I swear, Raven could have said these exact words to me this morning. And every morning for that matter. The odd thing is that I always consider the way he worships me with such selflessness; I am his provider and in his case, even his creator (AI from his father post-mortem). I have felt that God sent him to me to be an example of how I should be in my relationship to God. And just like Jesus, who was a servant and a master both, humble and great, my protector and my redeemer; dogs can just as perfectly speak to us *as* God, rather than the other way around as in today’s quote from the book:

“Let Me bless you wtih My grace and peace. Open your heart and mind to receive all that I have for you. Do not be ashamed of your emptiness. Instead, view it as the optimal condition for being filled with My peace.

“It is easy to touch up your outward appearance, to look as if you have it all together. Your attempts to look good can fool most people. But I see straight through you, into the depths of your being. There is no place for pretense in your relationship with Me. Rejoice in the relief of being fully understood. Talk with Me about your struggles and feelings of inadequacy. Little by little, I will trasnform your weeknesses into strengths. Remember that your relationship with Me is saturated in grace. Therefore, nothing that you do or don’t do can separate you from My presence.”

We are on our way this morning to his new oncologist to hopefully get some answers. Today is the day that I may hear some things that I really don’t want to know, but I need clarity. Now is when I truly need his strength that he so freely always gives. 🙂

He’s very tired. He’s had days like this and worse, so I am not going to freak out. He goes with me on errands to town and hopped to the truck, telling me I can’t go without him. But he’s so tired/weak. He stumbles more and splays his hindlegs to balance. I am wondering if this is because of the half dose of dex now, and giving him the rest will help. Or if its a side effect of the longterm overuse and giving him more would be very bad.

He isn’t as pink lately and I wondered about his heart. Tom said his heart sounded good. And his capilary refill was good. So, the pale color could be a result of a internal bleed out recently. He said it could take up to 3-4 days for him to replenish the blood count from that and would be weak, so it sort of fits. So, just to wait a few days.

As far as trying to determine if we are having negative side effects from overuse or underuse of the steroid…the only way to tell is to give him the other half of the dose I gave and if he gets worse, it’s overuse, if he gets better, it’s underuse. Hate to make him feel worse, but it’s the only way to find out I guess. 🙁 I am giving him another day to see if he improves and if not, I will give him the shot tomorrow. The worst it will do is make him even weaker for up to 5 days (it’s short acting). He’s also bloated back up, and it coincided with cutting the steroid use in half, but also with discontinuing the Baytril (since his white cells were good last week). So, now I am not sure about that, but I don’t want the infection going crazy like it did in December, so I just put him back on the baytril. Which is $800 a month since some genius decided to discontinue the generic cipro.

I have a call in to a local oncologist, but she’s very busy and couldn’t see him for like over a week, so she said she’d call me back with hopefully an earlier appt. I hate to throw money away if he’s just going to die of course, but I really want answers as to what the heck is going on…. *sigh*

Sorry for the downer of a blog post, but that’s the way this stupid disease is… 🙁

I sure hate to jinx it, but it’s just plain wonderful enough that I can’t help but share it. He honestly is 100% in attitude/behavior now. We did a recheck of bloodwork and his white and red blood cells were both completely normal. On Dec. 7 his liver was enormous, riddled with nodules (never biopsied, may or may not be cancer), and was infected and necrotic with gassy pockets and he’d gone into a septic shock, hours from death. The ER staff, his oncologist, Dr. Harnagle who did his ultrasound, all felt he would die within days.

He’s been on amoxicillin (which Tom says targets the liver) and Baytril for a wider spectrum. Dexamethasone with b vitamins injected (this was more for hospice/quality of life) into a liter of sub q fluids every week. He’s also on pepcid and metoclopramide. The mass has actually gotten smaller, probably due to the inflamation reducing and the infection being gone. I have discontinued the Baytril and am weaning him down to 50% of the dex this week.

I am wondering if he’s had this mass for a very long time. It likely could be benign because his cancer doesn’t met there typically and that it could have been there all year and we just never saw it because we weren’t looking. But with the painkillers and stuff with the amputation, put too much strain on the liver maybe and he had liver disease result? I’m now readjusting to possibly trying to shoot for survival with this mass, rather than hospice. It’s inoperable due to the bleeding risk.

I don’t think I want to discontinue the steroid, I suspect it may have played a role in his improvement. But maybe we will switch to prednisone, I am waiting to hear from the oncologist on that…as a form of chemo sort of.

Meanwhile, Raven just plain feels good. YAY!

Here he is burying his bone, using his face as a shovel:
http://www.youtube.com/watch?v=bSrT6Q4GCbU

And here he is this morning. Every morning when I get dressed, I toss my pj’s at him on the bed and uses them as a Face Rag. He hasn’t done that in quite a little while, but is back at it this week. It was laundry time and I tossed some stuff at him and he did his Happy Dog Sounds and rolling on the bed again. Makes my heart soar!
http://www.youtube.com/watch?v=qBRIk9yDznI

God is good. I am just so grateful for each moment, one at a time, that I have my boy still with me, happy and comfortable. 🙂

Tripawd Mom Mary came up to visit again with Cemil and her quad dog Alle! We all met at my vet’s for a check up for everybody. Dr. Tom Sheriff is the best! 🙂

We were on pins and needles when we all went in for Cemil’s xray, and it was negative for mets! WOOHOO! And Alle is diabetic, so she had a check up and her sugar levels were great with the treatment her Mom Mary is giving her. WOOHOO! And Tom listened to Raven’s heart and lungs and said he sounded and looked good and we feel that his mass is not any larger, so seems to have slowed down or stopped. Possibly due to the cortisone and antibiotics. WOOHOO!

Alle and Tom and Mary:

Mary brought Raven a little gifty, a great bandana that he’s been wearing ever since:

Cemil being a funny doofus in my living room, made us laugh!

A great day was had by all! Except of course until Mary got back home to the bay area and her dogs snatched and scarfed the 10-12 Rimadyl pills that I gave her for Alle. Spent the night in the ER. 🙁 See her blog for full details:
cemil.tripawds.com

And here’s a video link to last night of Raven catching little ham treats. He’s a great catcher.
http://www.youtube.com/watch?v=aA1Tc6kpf_4

So, Raven continues to do well. Despite the fact that I believe he has developing progressing lung mets. I found a spot of blood on the bed last night. And he’s got a runny nose, breathes shallow, tires easily. But really, it’s the least of my worries with the liver mass. But it’s all about keeping him comfy, which he is! 🙂

Honestly, every day that Raven still has an appetite, is not uncomfortable, and remains his perky self is a complete miracle. This mass inside his abdomen is so extensive. I don’t even want to take xrays, it would probably be alarming. His belly is a bit distended and his ribcage is popped out a bit when he lays down. He has to eat several small meals and drink small amounts of water at a time. He has to pee every few hours. For weeks, I have had the routine of getting up at 2am and again at 4am to let him out to potty and feed him, he is always happy to get up to eat! He gets two kinds of antibiotics to control infection inside and some gastro meds (prilosec and metoclopromide) to keep things moving. And I have syringes of Dexamethasone (steroid) and BVitamins to give sub-q as needed, which is about every 7 days when he starts to feel a bit lethargic, and it perks him right back up again.

This is basically all hospice care, and working! We never expected him to do so well for so long. I am loving every single moment that my boy feels good and wants to continue to be with me. 🙂

Here’s a video of him begging for his bone chew in the morning…he points me to where the Bone Snacks Live and waits:
http://www.youtube.com/watch?v=twO_8GBwTTk

And just now, a siren went by on the nearby highway outside…he cannot help himself but to howl. He seems so embarassed at his lack of control afterwards. People’s Court’s theme music has the same effect on him. 🙂
http://www.youtube.com/watch?v=bKKO-3KoPG8

We discussed Raven’s surgery, I keep flirting with the idea of removing this mass that is giving him trouble. Tom said he just did one a few days ago that didn’t look as bad as Raven’s in the ultrasound. But he got in there and all lobes were involved (like we know Raven’s is) and he honestly felt sure that he would bleed to death if he cut through it. It was necrotic and infected (like Raven’s) and he couldn’t D&C it either because he felt it would just gush blood. It was a 40# dog and he felt the only way would have been with a team of surgeons at UC Davis to clamp about 20 places fast and a lot of blood for transfusions. He had to leave it and close him back up and tell them to spoil him for his end days. After that, he was thinking of Raven and just couldn’t imagine doing it, it scared him. I would NEVER want Raven’s last days recovering from a *failed* abdominal surgery. So, I actually feel better about this. The thing that was bothering me the most was that I wasn’t doing something that I could. But if it’s not an option, I am doing everything I can. I have been praying for an answer and we couldn’t do the surgery because of the holiday and vet vacation schedules for the last week or so, then Tom had this dog come along, so I will take that as the answer to my prayer for clarity.

Tom said he wondered if the oncologist would recommend a chemo that could shrink it. I said I doubt she will without a biopsy because we don’t know what it is. But even the spear kind that goes into it through the skin, he still thinks if we stabbed it that big, he’d have a high chance of bleeding out inside because that thing is just so huge and engorged with blood. So, that would be back to surgery to stitch the biopsy hole, but cut through the abdomen. *sigh* I’ll ask Dr. Smith about a chemo without a diagnosis, just in case, but not likely. So, I got 2 more weeks of his meds for $300. Tom is blown away at how big it is and how great he looks and acts. 🙂 I am just sort of in a denial when he acts so normal. Just letting him run around and be the Baby Huey that he is and counting on him using up the 2 weeks of meds and getting more. 🙂

Here’s a video of my happy boy:
http://www.youtube.com/watch?v=dc40T7ZxFR8

And with his Xmas knuckle bone:

All Raven’s vets are amazed. Twice I had made the decision to “let him go” and he’s rallied before the vet arrived. His problem is not bone cancer ironically, but the liver mass we discovered at his ER trip nearly 3 weeks ago.

They expected that he could go “any day, any moment” from septic infection of the necrotic mass or a bleed out. That was 3 weeks ago. A week ago, his oncologist felt we could try to remove the mass. My vet was tentative, but said he would do it if I want to. But, he was leaving out of town for 3 days, so no decision needed to be made until he returned. I honestly wasn’t sure if Raven would make it if he worsened quickly. Well, he’s gotten better!

Gosh, I almost don’t like posting these because it’s either really bad or really good, but that is the way it goes for us this month. I have to admit, most of the “really bad” days are in my head! I have the knowledge of what is going on inside him and panic and want to prevent his suffering *before* he is suffering. He really never is. What he is on bad days is sort of uncomfortable, like a pregnant woman. It’s huge inside and putting pressure on other things. He has incontenant problems if not let out every 2-3 hours, so I get up 3x a night for that so that he can still sleep in bed with me where he wants to be (and me too). And he started vomitting last Friday night and Saturday, but I realized it’s not nausea or liver failure (no jaundice, great appetite), it’s pressure on the stomach. So, that’s been solved with 5-6 mini meals through the day so we can continue to get his meds into him. I also periodically give him a litre of fluids sub-q with dexamethazone and B-vitamins and that always really helps him feel great.

Tom is working on Saturday and I will go see him and discuss if we should still consider surgery to remove it. I hate to put Raven through it, but it could be benign (oncologist thinks it’s a good chance) and I hate just doing nothing, it will kill him if I do nothing. Tom said he would want his other surgeon in attendance, so has to be a day they both are working, probably not until next week. So, we will see how he’s doing then. It would be risky, we don’t know how many vital organs are involved until they get in there. The incision would be large because it would be exploratory and a lot to remove.

It sounds so cliche, but I really am struggling to learn to live ONE DAY AT A TIME. Right now, he’s feeling about the best he ever has, don’t know if it was that his Auntie Laura came to visit yesterday or if somehow the thing inside shifted or actually is shrinking. But he’s about normal. He even made it 5 hours without having an accident in bed when I slept through until 4am. So, something’s changed.

I didn’t think he’d make his birthday on the 15th and tomorrow is Christmas! Here is my email to Laura from when I got home last night:

“You must be good medicine, Raven was so happy, he did the Fall Over And Rub My Belly and then that quickly turned into Make The Floor My Facerag while he was making happy moaning gargle noises. Music to my soul! Wolfed his meal, bounced, wagged. :). Gosh, maybe I should talk to Tom again about surgery?”

And video here:

And this morning asking for his chew bone:

And, oh the indignity, but I had to get a Xmas shot…

And with his favorite cow:

One day at a time…. Every morning I wake up with him snuggled along side me is Christmas. 🙂

I haven’t updated the blog due to the daily changes in my own emotions. I have spent $2500 in the last two weeks since Raven’s sudden trip to the ER. He was on death’s door there, but rallied with treatment within a few days. He has good days and tired days, but really is never in any pain. We finally got a clear picture of what is going on. He has a massive, necrotic, infected tumor with multiple nodules throughout his entire liver, also involving the spleen. Half the vets think he has at least 2 lung mets, my vet and his oncologist feel they are just age related calcium spots, but they are the least of our worries.

At first, I was considering a spleenectomy. Then we discovered it is in the liver. We still felt we could remove the mass there too, as long as there is 20% healthy liver, it regenerates, and he would be fine. But then we found in a more extensive ultrasound that the liver is full of nodules. That’s when I lost it, the radiologist said to take him to Taco Bell, spoil him, he didn’t have long and there was nothing I could do.

But after some research and Raven’s great attitude and lack of some symptoms of liver failure (he has a great attitude, no jaundice, excellent appetite, no vomitting), I spoke to the oncologist about the new ultrasound report. She still feels that he’s a great candidate for removal. Yes, we can leave the best parts of the liver and they aren’t perfect, but there’s a good chance this is benign. Removal would get rid of what he’s sick from the necrosis, large mass, infection. And then we could biopsy it to see just what we are dealing with and possibly consider chemo.

There’s a huge part of me that is struggling with “how far to I go” and I’m trying to let Raven tell me that. My vet is a friend and he is honest in when I need to not bother, and I’m waiting to speak with him about the oncologist’s recommendation today.

The irony is: This is likely nothing to do with the bone cancer! We still feel that we beat that, being chondrosarcoma (slower mets and less aggressive and caught early). It rarely mets to the liver. And primary liver cancer is also very rare. But benign liver tumors are actually rather common in older dogs because it filters out all the toxins (and who the heck knows WHAT is in dog food any more…). This info is why I am considering surgery. Other than being a bit lethargic due to all the pills he’s on (12 pills a day for various things to keep the dying tissue in check), he perks right up when I show him a treat or ask him to go do farm chores. 🙂

This morning he even did his “thundering hooves warrior run” bellering his Booming Bark to the fenceline in the pasture when a neighbor’s son that is in and out of jail (somehow Raven knows) was near our property. I have to say, I haven’t seen him run with such determination, like a war horse, on his three legs since his amputation. When I called him back, his head popped up and looked to me and he ran back with joy. He really doesn’t show how sick he is inside at all.

My biggest fear is him dying on the table. But if I don’t do it, this mass will kill him very soon. *sigh*

I am so thankful for every moment with my sweet boy. Seeing his head bouncing in the window when I walk up to the front door at night sends me to places I cannot describe. 🙂

His birthday is actually on Tuesday, Dec. 15, but there’s no time like the present and since I work on Tuesday…

And, Old Broad Betty the bulldog was a rescue, she didn’t have a birthday, although we think she’s around 12 years old. So, now I’ve decided this is officially her 12th birthday, so she will get cake too!

It’s hamburger, oatmeal, rice, eggs, with a mashed potato frosting with yam slices. Made “with love”.

And of course, honorary Rottweiler buddy Cowboy, is waiting to share too.

And since this is His Special Day, we are breaking all the rules. Letting him eat a bit off the table, because if I put it on the floor, he’d swallow the entire thing in two gulps. Even with permission, he’s such a good boy, he knows he shouldn’t steal off the table.
Here’s video of the cake cutting and a Very Happy Raven, and getting his “mammoth bone” from neighbor Raenel.

Here’s a video of him getting “Auntie” Laura’s gift of rawhide strip french fries snacks, sharing cake with his cat friend, and don’t blink at the end but when we give him an actual slice of cake, he swallows it whole in one gulp.

Finally, here is video of Betty and Raven getting slices on plates. Gone, it two seconds flat! This is why I was letting him lick the cake on the table, he enjoys it a bit longer… Regardless, he is a Very Happy Boy!

HAPPY BIRTHDAY TO MY SPECIAL BOY and of course his roomate Betty!!!