Monday, 2/8/2010 = I just found this site today, so I will post my chronicles of Rusty’s cancer that I have been sharing with our closest friends.
Friday, 1/16/2010
Rusty has had a small bulge on the inside thigh of his left leg for several months, which our Vet thought was probably a muscle tear or a hernia. Around Thanksgiving it started growing and we took him back to the Vet in early December; she did a needle biopsy which was inconclusive and said let’s check it in a month. The growth has become much larger over the past month and she did another biopsy this week; she called Thursday night and said that the results came back 50-50 that it is malignant but the lab needs a larger biopsy to be certain. She scheduled an appointment with an Orthopedic Surgeon for 8:30 Monday morning for the biopsy, for which Rusty will be sedated. Our Vet said she did not consider cancer as a possibility until the biopsy came back, as it is extremely rare for a dog to have cancer before they are two years old.
The bad news hit us like a ton of bricks Thursday night; it just seems so unfair that this could happen to him at such an early age. We are doing a little better tonight but still have our tearful moments with him and holding our breath until next week’s results come back. It may be our imagination but Rusty seems to sense something, maybe our concern for him, as he doesn’t let us out of his sight.
We had him groomed today, back to a summer cut; we were really enjoying his shaggy looks but that requires daily brushing and it will probably be a while after surgery before he can be groomed.
Monday, 1/18/2010
Rusty was introduced to his new Vet, Douglas Huber this morning. We are very pleased with Dr. Huber; he spent an hour reviewing and examining Rusty before admitting him for a Tru Cut biopsy procedure. When we picked Rusty up this afternoon, he spent another 30 minutes with us as to his observations from the biopsy and a discussion of the next steps in Rusty’s treatment.
Unfortunately, Dr. Huber is leaning toward the tumor being cancer; he sent the biopsies to Colorado State University which he said has the best animal cancer labs and pathologists in the nation. He is hoping to have the results back Wednesday evening; if the results are malignant, Rusty will go back for X-Rays on Thursday to see if the cancer has spread to his chest cavity or internal organs. If it has spread internally, that could be the end of the road; if it has not spread internally, we will take him to San Diego on Friday for a CAT Scan. The CAT Scan will give Dr. Huber a three dimensional picture of the tumor and Rusty’s leg and he will perform surgery next week. He will not know if Rusty’s leg has to removed until after the CAT Scan. We are hoping and praying for the best possible outcome and that it has not spread into his body; everyone in the Dr.’s office said what a sweet and friendly dog he is, which all of us know.
Thursday, 1/21/2010
We talked to the vet a few minutes ago; not good news. Rusty has a fast growing sarcoma form of cancer but he will not know the type of cancer until he receives a more comprehensive report from the lab later today or tomorrow. He again said that it is extremely rare and very unusual for a dog of Rusty’s age to have such an aggressive form of cancer. We will take Rusty in at 1PM today for X-Rays to see if it has spread into his chest or internal organs. If the X-Rays are clear we will take him to an imaging center in San Diego tomorrow for CAT Scans of both his body and leg, as the cancer could just be starting in his body and not show up on the X-Rays. If the CAT Scans are clear he will perform surgery early next week. He said that Radiation or Chemo treatments would not be able to stop this type of cancer; if there is any chance for Rusty it is through surgery.
Thursday, 1/21/2010
Everyone, Thanks for your thoughts for Rusty and us; we just returned from the Vet and Rusty is sleeping as they put him out again for the X-Rays. The X-Rays were all normal and his blood work is normal which is step one. Jan asked when he would do surgery and he said let’s wait until we get the results of tomorrow’s CAT Scan & Ultra Sounds, as the cancer could still be there but not showing on a X-Ray. He did say that if Rusty is clean after tomorrow’s tests he would remove his leg Tuesday morning. We are off to San Diego tomorrow, the tests will take five hours; we hope the rain has subsided by then. Rusty will probably need to go through Chemo therapy after surgery as his sarcoma cancer is level three which is the most aggressive and still might be lurking in his body. The vet said that if everything goes well, Rusty should have one to three years of quality life and might even have five years.
Saturday, 1/23/2010
We had a long, tiring but productive trip to San Diego yesterday; we drove through snow, hail and rain so heavy that freeway speeds were 40 MPH. Fortunately, there were no accidents and most drivers were slowing down with the weather conditions. The imaging center moved us into priority status and processed Rusty quicker than their original time estimate so that we could avoid the rush hour traffic on our way home. The weather was the same for our return trip other than no snow.
The imaging center performed CT Scans of his whole body & left thigh region and Ultrasounds of his abdomen and heart. All of the Scans were clear and showed no signs that the cancer has spread into his internal organs. There are a couple of Lymph Nodes in his stomach that were enlarged but they don’t think it is from the cancer. The CT Scans of the thigh showed that the tumor is touching the pelvic region and is very close to crucial areas in his rear; the Radiologist is also a Vet and said that Dr. Huber would have a real challenge in making sure that he gets the entire tumor when he removes Rusty’s leg. The Vet also cautioned us that a recurrence is very likely because of the aggressive form of cancer and Rusty’s age. This is what Dr. Huber had also said when he reviewed Rusty’s treatment options, which is why he put Rusty’s life expectancy in the 1 to 3 year range, possibly longer or maybe only a few months. Because Rusty is so healthy otherwise, which we hope will allow him to fight any recurrence of the cancer along with Chemo therapy, we feel it is worth the risk of surgery to give him the extra time. I don’t think we are being selfish in our desire to extend his life; if he was going to suffer any pain or have a lower quality of life we would not perform the surgery. We are up against the clock as the tumor has grown significantly in the past five days and will spread internally very quickly if it is not removed.
Dr. Huber called us last night and again discussed our options. In his preliminary review of the Scans he feels confident that he can remove 100% of the tumor, which might also require removing a portion of the Pelvic region. The imaging center had transmitted the digital images to Dr. Huber and he has a program on his computer that allows him to construct a 3-D model of Rusty’s leg from the 2 dimensional scans. He is working on the model this weekend to plan his surgical procedures; we will take Rusty in at 7:30 AM Monday morning. He will again assess the probabilities that he can remove 100% of the tumor after evaluation of the model of Rusty’s leg. If we are all in agreement, he will then perform the surgery.
Monday, 1/25/2010
It has been a very long day! We took Rusty in at 7:30 AM this morning and the Dr. just called at 8:30 PM. The Dr. had hoped that Rusty would be prepped and the surgery would begin around 11:00 AM, but called us at 1:30 PM and they were just getting started. After seeing the tumor’s growth since last Thursday’s visit, he spent more time adjusting his plan of attack and getting the surgical team prepared. Rusty was in recovery when he called and he said that he was doing fine. The Dr. said that the surgery went as planned, without any major problems or bleeding and he was able to remove the tumor and leg intact; it will be sent to the Colorado State University Animal Cancer Center for analysis. The Dr. felt very comfortable that he was able to remove a safe margin of non-tumor flesh for 95% of the area; the 5% where he had to take less was in the area of the penis and pelvic bone and he could not take any more without causing damage to those areas. When he gets the reports back from CSU, we will know if he was successful in completely removing the tumor. It will probably be Wednesday before we can bring him home and it is doubtful that we will be able to visit him tomorrow as they are concerned that he would get over excited on seeing us. We are preparing our spare guest room for Rusty as he has to be kept quiet and closely monitored for 14 days after he comes home.
The Dr. is spending the night with Rusty! He has an inflatable air bed and will put that in the recovery room to sleep on so that he can monitor Rusty.
Tuesday, 1/26/2010
The Dr. called and Rusty is doing so well he wants us to bring him home this afternoon! He said that Rusty had recovered from the surgery much quicker than expected, probably because he is so young (18 months Saturday) and he thinks it will be better for him to be home in familiar surroundings tonight vs. spending another night in the hospital. He has bandages, a drain tube, etc. that we will need to monitor but we want him home too. Now we just have to keep our fingers crossed for a clean report from CSU, which will probably come Friday at the earliest.
Wednesday, 1/27/2010
Rusty’s first night home went very well; obviously he was exhausted and happy to be home. He slept most of the night and was not too active; the challenge will come when he is rested and wants to be more active. We have to keep him from running, jumping or playing with Oliver for the next 14 days, when the sutures are removed. He has one pain med that is given once a day and another that is given every 6 to 8 hours, depending on if he is showing signs of pain and an anti-biotic pill that he takes every 8 hours. He also has a vacuum pump connected to a drain line in the incision which has to be emptied and measured every 8 hours. We were up at 3 AM to give him a pain pill and empty the vacuum pump and again at 6 AM, which we are normally up anyway, for his anti-biotic. We have a couch and recliner in the room which allows Jan and I to stay with him. He is confused and bewildered, but still the same sweet and lovable boy he has always been. Oliver realizes that something is different with Rusty and wants to spend time with him.
Rusty is to get several small meals a day and so far readily eats everything put in front of him. He is also drinking a lot of water and piddling regularly. I lowered his potty box which enables him to walk in and out of it. We have a sling that goes under his mid-section to help him keep his balance when we take him outside for his business. We are keeping him confined to our spare guest room; we put down an area rug on the tile floor and he is able to get around fairly well on three legs. When he gets off the rug on the tile, he has more difficulty keeping his leg from slipping and maintaining his balance. We are looking at putting down additional area rugs or the self stick carpet tiles in the halls as this house is 100% tile floors. That way he will have more stability when he is released from his recovery room.
The Dr. showed us the before and after surgery X-Rays yesterday and reviewed the extent of his surgery procedures. In addition to Rusty’s leg, he removed a portion of his Pelvic bone. The before X-Rays depicted how much more the tumor had grown since he X-Rayed it last Thursday. The Dr. said that in another few days it would have been impossible to remove the entire tumor without impacting vital organs, which would precluded him from doing surgery. They shaved Rusty’s entire hind quarters for the surgery which along with the large incision, he certainly does not look like his before photos. The Dr. used the leg’s skin to cover the area where the leg was removed and when the hair grows out there should not be any noticeable scar line.
The complete leg and tumor were sent to Colorado State University to make sure the Dr. removed the entire tumor and perform additional analysis as to the type of tumor. The results will probably be back early next week. Further tests from last week indicate that the tumor is most likely a fibrosarcoma (tissue) which is less lethal than a hemangiosarcoma (blood); unfortunately, because it was a level 3 sarcoma which is the most aggressive, there is a 50% likelihood that it will recur in the future. The Dr. said that we will have to take an aggressive Chemotherapy program to knock it out. We will appreciate and enjoy every day that we have with Rusty to the fullest.
Monday, 2/1/2010
Rusty went to the Dr. this morning for his 2nd follow-up. The Dr. said that everything is healing as expected and he removed the drain tube, which should make Rusty a little more comfortable as he doesn’t have to wear the surgical sweater. Rusty’s next appointment is Sunday afternoon when Dr. Huber will remove his sutures; this week is going to be a challenge for us as the sutures are beginning to heal & pull and Rusty wants to get to them, which is a big NO NO. The surgery area is already showing improvement in appearance and he has a little “peach fuzz” hair growth coming in. Rusty was very appreciative of his outing, even going to the Vet where he loves everyone. The Dr. said that he could start having visits from his non-doggy friends starting Wednesday.
We talked to the Dr. this evening and he had just received the pathology results from Colorado State University; the report said that the tumor has “clean edges” which means Dr. Huber removed all of the tumor and a margin of clean tissue around it. Dr. Huber cautioned us that he is pleased with the report but that is not a guarantee that he removed 100% of the tumor as something could always be hidden. If the report had come back with “dirty edges” that would have required additional surgery or radiation. The report also indicated that with the larger tissue sample, the Sarcoma could possibly be a level 2 rather than the original level 3. Dr. Huber said that while level 2 was less aggressive than level 3, it is still a very aggressive form of cancer, especially in a dog of Rusty’s age. The report did not change his prognosis on the cancer returning in the next 1 to 3 years. After Dr. Huber removes the sutures on Sunday, we will spend an hour with Dr. Macy, who is an Oncologist and will begin Rusty’s Chemotherapy treatment at that time.
Rusty is learning to get up and down much easier now and even sat on his haunch for the first time tonight; his balance on three legs has also improved. He has to remain on a leash to keep him from trying to run or jump for another three weeks. Rusty’s appetite has returned and every day he is acting more like his old self, which is amazing as it one week ago today that he had surgery
Monday, 2/8/2010
Rusty saw Dr. Huber yesterday and had his sutures removed, for which he was very appreciative; Dr. Huber said that his recovery was doing very well and he did not see anything for us to worry about from the surgery. We then met Dr. Macy, the oncologist, who is very nice; he came in and said my name is Dennis and sat down on the floor with Rusty. Dr. Macy discussed the various Chemotherapy options that are available for treating Rusty (they are all the same drugs as used on humans, nothing has been developed for canines) and the two specific drugs he felt were the best for Rusty considering the type of cancer, the aggressiveness of it and Rusty’s age. We accepted his recommendations and he gave Rusty his first intravenous treatment; Rusty will receive the intravenous drugs monthly for six months. He also prescribed another drug that is given orally monthly every two weeks after the intravenous drugs. They will monitor Rusty’s blood counts, liver functions along with additional scans and X-Rays to make sure the cancer has not returned.
Dr. Macy hopes that this treatment plan may eliminate or delay the recurrence of the cancer in Rusty. The odds are against us that the cancer can be eliminated as the pathology reports on the tumor place the cancer as the most aggressive form possible; their prognosis is for Rusty to have at least 1 to 3 years of quality life; possibly more. Rusty slept for 12 hours last night after the treatment, but so far has not suffered any nausea or vomiting which are the most severe of the side effects of the drug. They did give him an injection to prevent these side effects and he has oral medication for the next four days to counter them. His appetite was good this morning and he is motoring around the house very comfortably, again very appreciative to no longer be confined to the recovery room; he hopped up on the couch in my office (with a little difficulty, but surprised both of us) where he is now fast asleep. Jan and I were back in our bedroom and our wonderful bed after sleeping on the couch and recliner in the recovery room the past two weeks.
