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All around today was just a good news day! First, Sunny slept through the night minus the part where I got him at 3:30 am to take his tramadol. Sunny has also been doing great today taking his pills. I’m now giving him a treat, then the pill pocket followed by another treat. He seems to just accept the pill pocket now in order to get the other treats. This morning I had to run up to the vet to get more tramadol so I decided to take Sunny along so they could take a quick look at his bruising just to be safe. It didn’t look worse, but since I was going there anyway I figured why not? Good news, looks fine and for now we aren’t going to do anything unless it gets worse. The vet said most likely when some of the sutures were removed a blood vessel that was being constricted bled a little. The vet said this can be common when you have a surgery as invasive as his. We are also still on track to have the remaining sutures removed on Saturday just in time for the holiday weekend. Also, just to be on the safe side we decided to go ahead and leave Sunny on tramadol three times a day until the remaining sutures are removed. At that time we will cut it back to twice a day and then discontinue it by next Wednesday. At that point he will be three weeks post surgery so he should be in good shape, but obviously we will watch for more bruising, etc. and reevaluate as needed. We will keep him on the T-reflief though since that helps with pain, bruising and swelling. Overall everyone continues to be impressed by how well he is doing. Yay!
The best news today came this afternoon. Sunny’s surgeon called to let me know they finally had the results of the post surgery biopsy back. We are officially cancer FREE and they are considering him CURED! While at times the journey has been rough this news makes it worth it. Sunny had a nerve sheath tumor so again this just validated we did the right thing since they have such a high rate of recurrence. All and all we couldn’t be happier.
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Now that we have made it through the first week after surgery we are looking forward towards the future. Lots of stuff will begin to happen over the next week as Sunny hopefully goes off all of his pain medications and get his sutures removed. Getting him off of he pain medications will be a big win for me since it will allow me I’m also happy to report that he slept through last night! I’m not sure if it was because he was tired due to our trip to GVR or because of the new homeopathic medications, but we were ecstatic either way. I’m hoping maybe he has turned a corner and this will once again become the norm. All that said we will likely stop giving him the hypericum. We have not found a good way to give it to him. He is not a fan of us just putting the tiny pills directly into his mouth (he actually spit one out) and he would not drink water that I dissolved them into. I was able to dissolve them into a very small amount of water I can put into a syringe and put directly into his mouth, but he hates it so much I have to wonder if the benefits out weigh the negative experience of him receiving it? At a minimum there is no way we can give it to him three times a day. Right now I’m just thinking this will be something we try in the evening before bed and if we are successful, then great, if not we may just have to give up after a few days of trying. It would be much easier if you could just give it with food!
Sunny ate what amounted to his full diet today for the first time since coming home even though it is still containing wet food. All in all he seems to be doing better with each passing day. We made more trips than we have been outside today and he showed interest in exploring the yard. All in all a lot of positive developments. I also started working with him on his at home exercises to help build his core strength. I know we still have a long road ahead of us, but I can’t help but start to see the light at the end of the tunnel.
We called BluePearl today to see if they biopsy results were back since they originally told us it would only be three to five days. They said they were still waiting on the bone to calcify. We couldn’t help but laugh imaging them dissolving the whole leg. In actuality though this likely means that the sarcoma had invaded the toe it was perched upon. It just reconfirmed for me that we made the right decision to amputate. Hopefully we will soon have the additional lab results to once again confirm this. They are still treating him as cured so we are optimistic this wont change.
And just like that, at the stroke of midnight Sunny began to vocalize. We went to bed last night around 11 pm and to our surprise and delight Sunny got into bed and went to sleep. I thought maybe we are going to be the lucky ones that got to sleep through the night! However, Sunny had other ideas. Just like in Cinderella at the stroke of midnight Sunny began to cry. From this point on it seemed like he had trouble getting comfortable and I could tell the tramadol was beginning to wear off. Each time he made any noise though I would go over to pet him, assure him he was fine and then get comfortable again so that hopefully he could as well. This seemed to do the trick. At 2 am he got his second dose of tramadol and after our trip outside around 4 am this really seem to kick in and he slept until around 9 am. Pete got up at 5:45 am like normal and had planned to feed Sunny, but he wasn’t interested in eating or going outside so he just let him sleep.
Around 9 am we got up and went outside, ate, and took our drugs. They only sent him home on two drugs (carprofen and tramdol) which has made things rather simple especially since the carprofen is just given with his meals. For the most part Sunny seems to be doing really well. He is doing ok getting around on just three legs and we are eating, drinking and going to the bathroom. His incision also looks really good. Originally I just took the photo below for our reference, but I thought it may be helpful in terms of preparing for those getting ready to go through this.
My only real concern at this point is carrying Sunny. We are still trying to find a way for him where he is comfortable/supported, but that I don’t feel like I’m going to hurt him. However, that honestly may be more me than him as he doesn’t seem too bothered when we do carry him. We have his harness, but just to be safe we were going to wait at least a week before using it. Given where his incision is I’m fairly confident we can use it without bothering him. He has spent most of the day in our bed napping which is good. I don’t think he is a fan of his new dog bed that we purchased. Maybe I’ll sleep on it? 🙂
We also talked to Dr. Winkler today to find out more about the biopsy they took during surgery. There must have been some miscommunication between the surgery team and the post-surgery tech because all they did was re-biopsy the lump on his foot. They just wanted to confirm that the initial diagnosis was correct and that he would need no further treatment which is their standard procedure. Otherwise, Dr. Winkler told us everything went great and looked good. That’s comforting to know. Although that also now has me hoping the initial diagnosis was correct so we didn’t take off his leg for no reason! In the end though, it looks like we will get our happy ending of a cancer free Sunny…
The results of Sunny’s cytology came back this morning. Great news! Just reactionary from the biopsy which means like we suspected the cancer has not spread. The results of this would not have changed our decision to amputate, however it was comforting to hear that the cancer has not spread.
Now that we have all of Sunny’s test results back we went ahead and scheduled Sunny’s surgery for this Wednesday at BluePearl GVS. I also went ahead and made his first appoint at GVR (GA Veterinary Rehabilitation, Fitness and Pain Management) for the following Wednesday. They wanted to see him 5 to 7 days post surgery. We had a dog who had to have back surgery and it was amazing how much physical therapy helped him get back to normal following surgery. I have to admit I was a skeptic before, however I’m now a firm believer. Hopefully this will help Sunny recover quicker. Initially we were concerned about doing such a major surgery at his age, but we have been assured he will do great. That said I feel like any boost we can him is worth doing.
Now all I guess there is to do is spoil Sunny and wait. While we have been through similar things with our other dogs, including major surgeries, in those cases we didn’t have any other options. We did what we had to do to get them through. Having choices this time has left me doubting, even though I know we are doing the right thing for Sunny. I know once Wednesday comes though it will all about Sunny and getting him through and on the road to recovery.
Every year as the weather in Atlanta warms up we tend to have our cocker spaniels shaved down. This year was no exception so while we were away on vacation in April we had Sunny groomed. Once he was shaved down we noticed a lump on the top of his back left foot. At first, based on how it felt we thought that maybe it was just something that needed to be aspirated by our vet. Unfortunately, this was not that case and once we realized it was a mass of tissue we had a punch biopsy done to determine what it was. Early last week we learned it was a sarcoma (soft tissue cancer). The upside is that while sarcomas are very locally aggressive (they spread into the fatty tissue, muscle and even bone) they have a very low risk of spreading through the body via the blood stream (10-20%).
Last Friday I took Sunny to met with a radiation oncologist and surgeon at the specialty vet in Atlanta to talk about our options moving forward. They did several chest x-rays and an ultrasound of his liver in addition to some basic blood work. Since those are the two organs that your blood flows through, if the cancer had spread this is where you would see it. Thankfully both came back negative for cancer and everything looked normal. The lymph node closest to his foot with the growth was slightly enlarged, but it is likely that the cause is in response to the biopsy. Either way they did take a sample and we should have the report back Monday. The oncologist seemed pretty confident that it would come back negative, but he wanted to be certain since a positive outcome would change how we need to treat Sunny.
All of these things taken into consideration left us with two treatment options. Generally, in this situation surgery with clean margins is enough. However, due to the location, it is unlikely that they can get the margins they would need so we would have to follow surgery up with 4 weeks of daily radiation. Going this route would have left us with pretty good odds (80% of dogs are cancer free at 3 years, 75% at 5 years), but there is a possibility the cancer could come back. Our second option is to amputate the leg. Given that the cancer has not spread they would consider this a cure and we would not have to worry about regrowth. We also learned that dogs tend to adapt better to loosing a back leg than a front leg since they put less weight on them.
Over the past few days we have done our own research and I have consulted with several of my vet and animal colleagues. Given that Sunny’s overall health is considered excellent and he has had no previous medical issues we have decided to amputate in the hopes of giving him the best possible outcome. We also factored in the fact that Sunny is not the biggest fan of the vet. While he tends to do ok once there, his overall personality is that of a shy dog and we were concerned about the stress caused by daily visits to the vet following surgery. I wouldn’t say it was an easy decision, but talking to others helped us determine that this was the best decision for Sunny and Sunny’s long term health.