Osa's Journey

It’s been almost a month since we lost our baby girl. It’s still really hard to believe that she’s gone. Death is just so permanent, and it happened so much faster that we thought it would. While we never did get an official diagnosis via biopsy, all signs point to Osa’s tumor being Chondrosarcoma. At first this seemed like a good news story. That did not end up being the case. The information that we found shows the rate of metastasis in cases of Chondrosarcoma is much lower than Osteosarcoma cases, which is a good thing if you can remove it through surgery. Unfortunately it is also very aggressive and grows very quickly, likely faster than Osteosarcoma. Osa died 5 weeks after her initial diagnosis, and 9 weeks after showing initial signs of very slight limping. We were too late to remove her tumor through surgery. By the end, she had a large tumor that was clearly visible and had made her entire right Gluteus Maximus swollen to the point where it affected her GI tract horribly. We tried various treatments, but ultimately I don’t think any of them did much to extend her life.

We live in Washington State, so were able to purchase and did have some success using Cannabis to manage her pain. I really wish we had discovered this earlier. Cannabis has shown some promising signs of being able to stave off and even reduce the growth of certain kinds of cancerous tumors in clinical studies. The sample sizes are small, and it’s certainly not conclusive, but I am hopeful that this has promise for future patients. The pain management properties worked well for Osa, seemingly better than pharmaceuticals.

Here are some things that we tried. Some seemed to work, some did not, and some it’s just too hard to really know.

What did seem to work:

Acupuncture for pain – we had this done 3-4 times with seemingly noticeable alleviation of pain, mostly the next couple of days after treatment.

Cannabis – We used a product called Canna Companion for pain. We also a tried an experimental therapy with high CBD Cannabis Oil (similar to Rick Steven’s Oil I do believe), which can help with pain and also is being investigated as a natural form of Chemo. The ratio was a 2:1 CBD to THC ratio which is supposed to be very important, as dogs don’t react all that well to high amounts of THC. I tried the oil mixture myself after she died and did feel quite high, but also very relaxed. This may be a controversial route for some people, but I honestly think that the Cannabis made Osa much more comfortable than the pharmaceuticals. If nothing else, she was relaxed and slept much better than she had in the previous weeks. These were both done with the guidance of a vet and the dosages were very specific.

What didn’t really work

I am not a big fan of pharmaceutical pain killers, especially using multiple different drugs in combination. I understand the principle of multimodal pain management, but it just never did feel right to me. After shoulder surgery I ended up just taking ibuprofen after 2 days of vomiting nausea from narcotics, so in all fairness, I’m a wee bit jaded. Osa’s vet prescribed a cocktail of Gabapentin, Tramadol, and a third that I can’t remember which acts both as an antidepressant and a pain killer.  We tried these to varying degrees, but never did go to 100% dosages on any of them. The thing is, she did not react that well to them. Her stomach seemed to react negatively with increased burping and farting, and her pain didn’t appear to subside to the point where she could relax for long periods of time. She was anxious and uncomfortable. Of the 3, I would say that Gabapentin seemed to work the best for Osa, and we continued to use this in conjunction with the Cannabis, albeit infrequently.

What may or may not have worked

Did I mention that we tried a lot of things? Well we did, and I mean a lot of things. Here are some that I really have no idea if they helped or not. My gut feeling is that the Chinese Herbs did help a bit in pain management, but I could be wrong. I really am not convinced that the others did much of anything…again, I could be wrong. Before her diagnosis, we did have Osa on a mostly raw diet combined with some high quality supplements, so the Poly MVA and Green Lipped Mussels may work better for animals that are on less healthy diets to start with.

Stasis Breaker – Chinese Herbs

Bone Stasis – Chinese Herbs

Poly MVA – high dosage antioxidant…very expensive, smells awful and should be administered orally with a syringe (non needle variety) because your animal probably will refuse to eat their food if it’s mixed in.

Montana Yew Tip – We tried this for a bit, but ended up backing off the last couple of weeks because we felt like we were just giving her too many things at once.

Curcumin – a natural pain killer that has Turmeric, a supposed natural cancer fighting herb

Green Lipped Mussel

Artemisinin – we never tried this, but I did come across it in my research

In the end, cancer is a beast that usually wins, especially in animals when surgery to remove the tumor is not performed. We did not want to give up and just manage her pain, we wanted to fight it and win, at least temporarily. Unfortunately we did not get the results that we hoped for. I don’t say this to discourage you from trying. On the contrary, this treatment path took us precious weeks of research to figure out, and my hope is that Osa’s legacy can be to help other’s find information more easily. Please also read my previous post for more insights if you like.

I will offer this advice no matter what approach you take. Enjoy every single day you have, and when you are with your pet, please try to be in the moment. Be thankful for the time that you have, and try not to focus on what the future may hold. Be a strong pack leader as much as possible. Worry and stress will not help you or your pet. Whether you beat the beast or not, be there for your furry kid as much as you can. Hold them in your arms. Tell them you love them. You will never regret it, that I can guarantee!

 

 

We lost our baby yesterday. It’s surreal, raw, and completely overwhelming. She was an amazing soul and will be missed dearly. The tumor was very aggressive and caused a rapid decline in her health over the last two weeks. In the end, her right gluteus maximus was very swollen from the tumor, to the point where is was affecting her ability to defecate and urinate, and she had a very hard time getting around or lying on her right side. She held strong until the last few hours and gave us everything she could. As always, she handled things the only way she knew how, like a warrior, strong and stoic. We made the decision to end her life so that she could die with dignity yesterday afternoon at our house. She was surrounded by her family and died peacefully. It was the right decision at the right time, I know that in my heart. We love you Osa. We will see you again at the rainbow bridge my sweet sweet girl!

This experience was, is, and will continue to be so hard, so painful emotionally. I wish I knew what I know now before her diagnosis. Here are the things that I hope may help others in this situation.

1. You know your animal better than anyone – If something seems to not be right, force the issue. Three weeks before Osa’s diagnosis, our vet told us she thought the limp was probably due to her tweaking her (TPLO repaired) knee, even though we said we thought it was her hip. Trust your instincts and make your voice heard.
2. Don’t be afraid to ask for help and advice – We found a lot of people who were so very generous with their time, advice, and even donations or discounts on medicine, treats, and other products. Vets, people who owned medicinal companies, and other dog owners who never expected anything in return. There are passionate animal lovers out there who are trying to cure cancer, or who just want to help you and your animal through these tough times. Ask them for help.
3. Try to be in the moment – It’s very hard to deal with this devastating disease. There are stories out there of dogs beating cancer, but in the end, make sure that you are there for your best friend every moment that you can be.
4. Make informed decisions that you feel good about – Make sure you are focused and educated on what the options are and don’t get forced into anything you don’t understand or aren’t comfortable with. Like I said, YOU know your animal and your situation better than any “expert” does. Make sure you understand any procedures and the possible outcomes before you have them done. Do your research and ask questions, ask questions, ask questions, so that there are no bad surprises. Things move fast and can be overwhelming to think about and deal with. Medical procedures can be very invasive and expensive, some of them are irreversible. They are not always the best course of action. Know exactly what you want to gain at every step of the process and weigh the likelihood of that gain against the potential risks and side effects.
5. Move Fast – Their toughness tends to be their downfall. Osa was tough as nails, so by the time she showed us signs of her pain, the tumor was already very advanced. From what I’ve learned, that is the case most of the time, especially with bone cancer. MOVE FAST if you want to try and beat cancer with an amputation or other surgery. Clinics and labs are likely not going to move as fast as you want them to…again, force the issue. Absolutely nobody cares for your dog as much as you do. Ask them to stay late, ask them to come in on their day off, the worst they can say is no. If they say no, look around for other avenues.
6. Don’t look back – Believe me, this is hard. Hindsight is 20/20. I can’t help but wonder what would have happened if we had forced the issue and been 4 weeks ahead of where we were when we received the diganosis. In the end, this is a recipe for heartache, blame, and guilt. I am at peace with our situation, I know that we did everything we could, and we made the right decisions for Osa and our family. Did we make mistakes? Probably. I wish with all of my heart that it had turned out differently, but it didn’t, and there’s nothing I can do about it. Blaming yourself for not doing things differently will not help heal or bring back your buddy.

Thank you to all of the wonderful people here who have had kind words for me. Writing and sharing this experience has certainly helped me cope with this journey. Please do not hesitate to reach out if you have questions or want advice. After the CT scan ruled out surgery, we took a holistic treatment route, including acupuncture, Chinese herbs, and cannabis (which really did help make her comfortable, and has shown potential of acting like a natural chemo alternative) and did countless hours of research. I will end this with a picture of our sweet girl on her last day, enjoying a trip to the park with her mom, brother, and I. It was a beautiful moment, one that I will always cherish. To the bridge my love!

We decided to have a CT scan and skip the biopsy, which was semi invasive, and probably would not have altered our treatment plans either way. We are very happy we did it this way, as at least now she doesn’t have to spend precious energy healing from the biopsy (surgery). The results of the CT were not good. The surgeon does not have the margins he needs to get the entire tumor, putting the chances of less that 50% for a curative surgery even if it were an isolated tumor.

On top of that, a nearby lymph node looks like it probably (75-80% chance) has cancer in it as well…meaning metastasis has started. Upon further questioning, our oncologist summed it up as once it’s in the lymph nodes, it “on the highway”. Radiation is a semi-viable treatment option, but would require 3-4 trips of 4-5 hours (seriously…we live in Seattle and I need to drive to Portland or Pullman…unbelievable). This in itself isn’t a showstopper, but because it’s likely affecting a nerve, the odds that it will dull the pain significantly are low (somewhere in the 20-40% range), and even if it did, we’re looking at 3-4 months. Not to mention the risk of colitis if we make it more than a few months.

We could continue to grasp at straws, but the long term prognosis is grim, which brings me to what really matters. NOW! It’s ridiculously hard not to be overwhelmed by the idea that my baby will probably not be here for the holidays, and I can’t say I am great at this yet. But this is Osa’s gift to us. She’s helping us realize that we need to focus on what is truly important, the only thing that we really have control over. Today, as in right now, this very moment! She has helped me realize that I have spent far too much time focusing on things like retirement, a potential future vacation home, trips to far off destinations, stock portfolios, promotions at work, social media, etc. Those things deserve some thought, for sure, but not at the cost of being truly present with my family, my beautiful wife, kids, and dogs. That’s the beauty of dogs, they don’t give a rip about tomorrow, probably don’t even understand the concept. That’s the gift that Osa is sharing with me. It’s a hard lesson, but also a beautiful one.

Here are some photos of my professor in the moment. On that note, I’m out!

After the initial shock had worn off, we got to work. What is bone cancer, is it a death sentence? Can we fight it or is this the end? What the hell is a Tripawd…oh I get it, that’s cute. WAIT, WHAT, cut off her leg, are you freaking kidding me!?!

As most of you know, these are the things that you wrestle with once you come out of the fog of a cancer diagnosis. We are still gathering information, but we know a heck of lot more than we did, and as they say – knowledge is power. Problem is, knowledge also means you start to understand that you will have to make choices and answer soul searching questions. Not easy everyday choices and questions, but like, really mind-bendingly hard ones.

Choices and questions like;

• Should we accept that this is the end after 13.5 years and just manage her pain until she can’t bear it any more, or should we fight this damn thing with everything we’ve got?
• Does amputation of a 13 year old 75lb dog even make sense or is it just plain stupid?
• Would this be the best thing for our baby girl, or are we doing this for us?
• What if her one good back leg isn’t strong enough?
• Holy crap, how much $$ is that?

Like it or not, this is the new reality. The reality where you get to essentially play god and decide the fate of your beloved companion’s life trajectory.

Here is what we know.

• The tumor is on the non weight bearing portion of her pelvis on her right side. It’s malignant and has done a lot of damage to the bone.
• The blood work and lung x-rays are clean, no visible metastasis
• Even though she is 13, Osa is in amazing shape, and doesn’t appear to have any arthritis in her other joints
• She still has a sparkle in her eye, and the appetite of a lab. This girl aint ready to quit.
• The radiologist and oncologist think it’s very likely chondrosarcoma, not osteosarcoma (on a side note rant, OSA is the acronym for Osteo? Seriously, wtf…not in THIS house!)
• The surgeon thinks it’s doable (based on the incomplete data set that x-rays provide), but a hemipelvectomy on a large breed 13 year old dog scares the crap out of me!
• We need to do a CT Scan and Biopsy if we decide to go after that sucker

That’s all for now.

 

 

The C word…CANCER. I’ll never forget the moment that I heard it, bone cancer to be more specific. It was barely audible through the sobs on the other end of the phone. The world slowed, then stopped, then started spinning. Fuck! That was one week ago today. What a week it’s been.

13+ years ago, we met one of the most beautiful little souls the world has seen. Osa was 8 weeks old when she and her sister were shoved under the fence at a rural shelter in the middle of the night. It could have been a terrible ending to the story, but instead it was one of the greatest things to ever happen to us. Two weeks later, we received the gift of pure love when she came to live with us.

Hundreds of hikes, camping and backpacking trips to the Cascades, beaches on the Puget Sound and Oregon Coast, about a million cuddle sessions, and countless wonderful moments later and here we are. The path to discovery of her tumor was a typical one, a minor limp that gets a bit worse, a “wait and see” diagnosis by our vet, wasting precious weeks waiting for improvement that never comes. Then the fateful x-ray reveals the savage, soul crushing truth. Osa has a malignant tumor in her pelvis. Fuck! So this is how it’s going to end?