One man's commentary on his dog's cancer
Holly's Story, Part 2
Saturday, July 12: On Saturday, Holly was due for her second chemotherapy dose. Rather than run her down to the emergency vet on another busy weekend day, we opted to have her get the shot from one of our local vets, who was experienced with the treatment. There was a problem with scheduling the injection, so we left Holly there while we dealt with a local fundraising event and came back around noon to pick her up. It turned out they had trouble with the injection -- Some had spilled outside the vein, which was a problem because the chemical is very strong and can kill the surrounding tissue. It was extremely annoying to have this happen with the most experienced chemotherapy doctor in the practice -- Now not only were we worried about the cancer, but we had to also look for signs of the tissue in her leg getting necrotic.
Sunday, July 13: The day started out very badly. Holly ate breakfast and vomited almost immediately. I called the emergency vet hospital, where our oncologist was located, to see if I could talk to him about what might be going on. I was concerned that maybe the spilled injection might cause the vomiting, but the oncologist wasn't available. Talk about frustrating. On top of this, because she was vomiting, she wasn't able to keep the antibiotics down, and they were critical for fighting any infection she might have from the ruptured intestine! Next, our local vet called to tell me that she had some new antibiotic pills for Holly (Baytril) because some new culture results had come in and the antibiotics she was taking weren't adequate. Our vet suggested waiting for Holly's stomach to settle, then trying a "bland diet" of cottage cheese and rice. We tried this and once again she vomited immediately. I was starting to get really worried -- she had been on the wrong antibiotics all week, and now she had no chance to keep the new medicine down! I checked her temperature again and it was elevated. Finally, I took her down to the emergency vet -- Surely they could put her on I.V. antibiotics to get the infection under control. They did, and we had a discussion about what might be going on. There were several possibilities: An infection, an additional tumor blocking the intestine, or the intestine had ruptured again. After some time on the antibiotic, her temperature was still elevated, so we made a decision to operate again and see what was going on. I told them that if the cancer was back, they should simply not wake her up. After a few hours, the doctor came back out and told me that they had cleaned up some areas of infection and they had stitched a patch over an area that looked "questionable", just in case it was a tumor that might rupture later. I was relieved that it was "just an infection" and figured that, now that they knew what they were fighting, Holly could get back on the road to recovery.
Monday, July 14 - Tuesday, July 15: Holly's infection was still not under control. Her temperature was elevated, she wasn't eating much, and had serious diarrhea. Her abdomen was still draining a lot, and she was using a lot of albumen. This was a concern because it was human albumen, which could cause various reactions down the road. The biggest concern was that her white blood cell count was down, and she was very susceptible to infection at this point.
Wednesday, July 16: The infection was still running rampant. I called the vet in the early afternoon, and there was no good news. They were still hoping to get more information on the infection from cultures. My wife and I took my mother, who was visiting from Missouri, to an outlet mall north of us and made several calls from the road. We also spoke to a dog breeder friend who worked for a major pharmaceutical company, and offered to get us some of the more powerful antibiotics. That evening, I went to visit Holly by myself. When I arrived, they told me that Holly's fever had broken, she was eating a little and it looked to me like things were getting under control. I went in to see her and had to wear rubber gloves to cut the risk of infection. She had more shaved areas, under her tail, etc. due to the diarrhea problem, which were very sore looking. She was wagging her tail when she saw me, though, and seemed fairly "up" considering her ordeal. When I left, I called home from the parking lot to tell my wife how she looked and that the fever had broken. As I talked on the phone, I looked down and saw an old penny lying on the parking lot asphalt. I picked it up and put it in my pocket, thinking that if there was any good luck in it, Holly could use it.
Thursday, July 17: I stopped by the clinic in the morning with some chopped chicken and broth to see if we could boost her appetite and get some protein into her. She ate some. I visited again that night, and she was still more or less OK -- At least there were no setbacks.
Friday, July 18: I went in Friday morning to check up on Holly, and she was still looking OK. My wife went with me that night to visit, but only I went into see Holly. She was still draining a fair amount of fluid and getting IV fluids and albumen. Once again, the bill payment issue came up, they wanted another $2000 and wouldn't take my personal check! This was just insane -- I had spent many thousands of dollars at this point and couldn't believe they would do this to me.
Saturday, July 19: It was "Fish Day" in our hometown, the big summer festival. I went to breakfast with other city officials as part of the usual proceedings, killing time waiting for my bank to open. I went to the bank and withdrew $2000 in cash so I could pay the vet. I went to the clinic to visit Holly and made my payment, pointing out my anger at having to deal with them on these terms. Holly was still looking pretty good, and if I remember correctly, all the IVs were out. That night, my wife and I went to the clinic and both went in to visit Holly. Now she had an Elizabethan collar on and a medication tube in her nose. She was obviously pretty irritated by this. The tube was held to her muzzle and nose with small sutures. My wife was understandably shocked by Holly's appearance. We spent some time with her and fed her some sliced ham and turkey. After eating this, she looked a bit like she wasn't going to keep it down. I took her outside to see if she needed to relieve herself or vomit. She didn't. We spent some time with her then spoke to the doctor. My wife was frank -- Are we working to save her or just to get her to the point where she could go home and die? The plan was to get her home ASAP and recover. Home should be a better place for her attitude to pick up -- We agreed, and said we'd be willing to learn how to deal with the abdomen drains and other aspects of her care. We really felt pretty good at this point -- We figured we'd have her home the next evening.
Sunday, July 20: I went in that morning with a Tupperware box with more turkey and ham. Doctor Grogan came out and told me that Holly had taken a kind of a turn for the worse, that she was going to have to be hooked back up to IV fluids and albumen again because the drainage was still too high. This was a blow. It meant we weren’t taking her home that night. They brought Holly out to the reception area and she wagged her tail when she saw me, and almost bolted for the door, she wanted to leave so badly. She looked kind of down but I put that down to the E-collar and tube being uncomfortable. They took her into the exam room and I talked to the doctor for a minute, then she left to deal with something else. I sat with Holly and petted her for about ten minutes – She looked pretty bad, exhausted. She fell asleep on the floor while I petted her. After a few minutes of this, she got up and started pacing like she had to go outside. I took her leash and started to guide her to the door and she squatted and peed. I grabbed some paper towels and was going to clean it up and I noticed a couple of other spots, one where she had been lying down – brownish liquid. She was standing by the door and squatted as if she was going to poop, and out came what was basically clear water with a few solids in it. She then started pacing around again, looking miserable. I went out and told the receptionist we were having a problem, and a minute later the doctor came back and looked at the scene and commented that Holly had thrown up. This is how bad it was – the doctor thought what was coming out of Holly’s intestines was watery vomit. I told her what it was and she looked kind of shocked. She ushered us into the next exam room, where Holly kind of collapsed in one corner. I thought about what was going on and came to the decision that Holly had gone through enough. I couldn’t stand the idea of the poor dog being hooked up to more IVs and made to go through more days in the intensive care ward with no end in sight. When Doctor Grogan returned, I asked her: Something’s very badly broken inside Holly, isn’t it? She’s not going to get any better, is she? I don’t remember the doctor’s exact response, but it wasn’t encouraging. Holly had a terribly compromised immune system and just couldn’t fight off the infection that had a foothold inside her. I told the doctor that I wanted to end Holly’s suffering now. There was no longer an IV port in her leg, but the doctor said that she could run the euthanasia drugs into the abdominal drain tube and Holly would die probably in under an hour. I filled out the paperwork, authorizing an autopsy. If they could learn anything about what was killing Holly, I wanted them to be able to use it on the next dog with the same situation. The doctor then injected the chemicals. There was a short panic reaction from Holly as the fluid was injected, then she relaxed and laid down on her right side. Doctor Grogan took out some small scissors and said “let’s get rid of this nightmare” and took off the e-collar and snipped the sutures holding the tube to Holly’s nose and muzzle, getting rid of the tube. The doctor then left. Holly lasted about ten minutes. I watched as her breathing slowed and stopped, then the slow pulsing of her chest from her heartbeat eventually faded away. I sat there for several minutes and stroked her beautiful fur and rubbed her ears, telling her how sorry I was and that it would never hurt again.
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