When Cancer Comes Calling
JJ was my partner not only at work, but also as my teammate in volunteering for HOPE Animal-Assisted Crisis Response. Each year, before we renewed our membership, JJ was required to undergo a physical exam. In December of 2016, during her veterinary exam, I asked to add a blood panel as it had been a couple of years since she had anything checked. She was six years old and it was a random request on my part. She had just started to have some excessive thirst and urination the day before and acted tired, although nothing abnormal showed on exam. My nurse brain immediately thought to have her kidney function and glucose levels checked, easily done through lab work, but I really wasn't worried about it. Three days later, I hadn’t heard the results, so called the clinic. We were back at work on a Monday and I asked to have the results faxed over so I could look at them. By the time I was able to take a break and scan the lab findings, I saw all was normal except for a very high calcium level. While we had to wait several days for a consultation appointment with a specialist, I tried to be optimistic that the cause of her high calcium and corresponding symptoms had a surgical fix due to an endocrine gland gone haywire. However, I had done my research and I was not surprised during our visit when I heard “lymphoma.” Still, my heart sunk to my feet and my stomach was in knots. On the drive home, it struck me how we had been down this exact path before. When JJ was just 9 weeks old, her nanny Callie was diagnosed with lymphoma at 6 years old in December of 2010. Now, we had the same diagnosis in the same month at the same age, as our young puppy Bria, who JJ nannied, waited at home for us. The similarities were uncanny and all I could think was “not again.”
While in the past we chose not to treat cancer in our dogs, given the diagnoses came late in the disease process, this time we all felt we had caught the cancer early and had a chance to buy some time with chemotherapy. Realistically, canine T-cell lymphoma is the more aggressive type and even with treatment, only 50% of dogs treated live past 4 to 6 months. At the time of JJ’s diagnosis, all her symptoms were a result of the high calcium level. The goal with starting chemo was to alleviate these symptoms and slow down the progression of the cancer. She also was started on prednisone, a steroid, for a short time. We often use steroids for symptom management in hospice patients, so I am very aware of its side effect causing appetite stimulation. Some people can get to the point where they want to eat almost around the clock. Animals are not different, and JJ was in constant search of something to eat. Her charming, mooch behavior rocketed to a whole new level when on the prednisone. Luckily, we tapered her off this medication within a few weeks and her ravenous appetite subsided somewhat.
At the time of diagnosis, I made the decision to be transparent about all we would go through on JJ’s Facebook page. I had spent years sharing about end of life and hospice, so focusing a bit more on these issues with our pets made sense. My experience over the years has shown that if anything, coping with end of life decisions and grief for our pets can be so much more intense than even family members. I am a pragmatic hospice nurse after all these years, so knew what the eventual outcome would be, even if I did not know the timing. I had spent years sharing JJ's voice, silliness, and compassion, all while building a large community around her. I knew I would be able to multitask and help guide people through this journey as a hospice nurse, while taking personal time and energy at home to cope and grieve with a very difficult situation.
We chose to transfer JJ’s care to Oregon State University, where they have a vet school and teaching hospital. They are closer in proximity to us and have access to the latest cancer treatments. When I first called, they were booking new patients almost three months out. Once they reviewed her records—the prognosis of dogs with lymphoma is only one to three months without treatment, so time was of the essence––they found a way to fit her in and we had our first appointment three weeks later. We didn’t want to wait to start treatment, so JJ received her first two chemotherapy treatments at the specialty clinic before transferring to OSU.
When vets say dogs in general tolerate chemotherapy well, they aren’t kidding. In people, chemo is given in search of a cure, which means higher doses that cause many awful side effects. Honestly, it takes humans to hell and back. As pet owners, it would be a rare person willing to do the same thing to their animal. The focus on veterinary treatments are instead palliative in nature. Palliative care focuses on quality of life when choosing treatment options. Animals are given a less concentrated amount of chemo with the goal of slowing down or stopping the cancer without making them miserable. From my first discussion with our oncologist at OSU, I was reassured that she had this same approach. We all knew we were buying time from the beginning, though as in hospice work, there is no crystal ball.
Through the generosity of JJ's many followers, we knew we would be able to get her the treatment she required without a second thought. We were, and remain, incredibly thankful for this. What we didn't know when we transferred to OSU was how much time we would have with JJ.
i still tear up a lot looking at JJ's pictures on my phone!!! i miss the interference from her...of me trying to use the computer when she wanted attention. She was persistent in getting my attention. Eating watermelon, string cheese, and jerky will never be the same. I loved her but am also excited to see Ember coming to join us at work.ReplyDelete
Thanks for sharing it all, Tracy!!!
You will be happy to know Ember loves watermelon!Delete
JJ and Tracy, our good friends. I love the memories and continuing to follow you Tracy, as you move along with your next adventures. As with any cancer journey, it is a complete roller coaster! With our dear boy George, we had a successful outcome with treatment of a rare form of osteosarcoma. It involved radiation and chemotherapy. When Tracy says dogs are completely different then humans in how they handle the chemo she is not kidding. Our boy was the poster child for not only tolerating the treatment but greeting each day and each person he met at the Oncology Center with utter joy. We had another year with him, then this past August, he started having a slight cough. We took him in right away and our vet found lung cancer as a primary mass, rather then a metastatic event from the bone cancer. So, a brand new cancer. We went back to our Oncology vet, with the hope that a new radiation treatment could save him again - after all he was King George, the wonder dog. It was too big and growing too fast. The chemo drug Palladia was prescribed to try to slow the growth down. The oncology vet told me that without it he might have a month to two months. We used the Palladia, it did cause him to have some loose stools but other then that his quality of life was great. The mass continued to grow but it was at a slower rate. At about four months, the mass had grown to the point it was pushing against his heart. You could actually see and feel his heart beating against his chest wall. He was still loving life, but it was beginning to hurt, he didn't want to eat much. His last day, we went for a lovely walk, he scared up some lizards, ate some cat poo and generally had a fine time. While I miss him with every fiber of my being, I wouldn't change a thing about our time together.ReplyDelete
George! These dogs of ours. <3Delete
George and Tracy, true dog lovers. Your shared experiences are so heart warming. Tbank you both.Delete
I had no idea I could fall in love with a dog on the other side of the country without even meeting her, but I did. That’s a testament to you too, Tracy. You both came into my life just when I starting needing it the most. Thank you for being strong enough to share her and her story with us all while coping with your own anticipatory grief. ❤️ReplyDelete
Thank you for sharing your journey with us and helping to educate us dog parents on what it's like to deal with canine cancer. It's been a godsend in determining how best to treat Scout. THANK YOU!ReplyDelete
Hugs to Scout.Delete
I first found JJ’s page because someone shared “The Video”. My family’s experience with hospice care for my mother and her war with cancer is why I joined JJ’s community of admirers (the fact that she had the same coloring as one of our beloved Goldens who is now at The Bridge was a bonus). But being able to compare our experiences as “Canine Cancer Parents” when one of our Senior Eskies was diagnosed with Osteosarcoma brought me more peace of mind than I can ever express. We had to let him leave us not too long ago, and now we’re dealing with our other senior recuperating from Soft Tissue Sarcoma surgery. The cycle continues, and I am consciously taking a page from your book and sharing the ups and downs with our family and friends. *Thank you* for sharing as much of JJ’s journey - and of yourself - as you have.ReplyDelete
Tracy, once again, thank you for sharing JJ with us.ReplyDelete
My only regret is;being on the east coast I never had the chance to meet you and JJ.ReplyDelete