As a veterinarian, I treat many of my patients for all different types of cancer. I’m a mixed animal practitioner and not an oncology specialist by any stretch of the imagination. In fact, as a mixed animal veterinarian, I like to joke with people that I’m a jack of all trades, master of none. However, as you can imagine, I diagnose many patients with cancer each year. My role can vary from counseling them on treatment options, performing surgery to remove tumors, monitoring while they receive chemo, radiation, or more advanced treatments from a veterinary oncologist as their primary care veterinarian, to just helping them keep their pet comfortable so they can have more time to say goodbye. But like many things, despite being a veterinarian, I never truly understood the process of having a pet with cancer until I experienced it myself. Here is my story. It was a hot day in late June, just two days before my husband and I were going to leave on our vacation to Oregon and Colorado. Of course, I was excited as I hadn’t had a “real vacation” in two years that didn’t include either a veterinary convention or a track race. My husband is a professional racewalker, so the first part of our vacation we would be in Eugene, Oregon, for the USA Outdoor Track & Field National Championships. Once that was over, I would have a REAL vacation of hiking and relaxing in the wonderful Rocky Mountains of Colorado. I looked over at my dog Shalane as I was packing, and I noticed a lump on her lower eyelid. I didn’t think much of the lump on her eye as she is a young, healthy dog. Of course, I performed a standard ocular exam and everything was normal. I just assumed she got herself into something she shouldn’t have, possibly getting stung by a bee. My mother was kind enough to keep her for us while we went on vacation, so I left her with an eye ointment and a few other medications to give while I was gone. My mom gave updates on her throughout our vacation. She loves her “granddog.” The vacation was great and just what I needed, but it included a few hiccups. My husband lost his wallet at a gas station in Colorado. We had to cancel our credit cards, of course, but I didn’t worry because we had enough cash to get us by for a couple of days while our credit card company express mailed us new cards to Colorado. Also, there was a hiccup in that process and we were steadily running out of cash. The Western Union site was also down, so attempts to transfer money were not working. At one point, I wondered how we were going to get money for gas to get home. And I was growing very tired of PB&J. Things worked out and we were able to enjoy the rest of our vacation. My husband also received third in the 20k, so he redeemed himself from his forgetfulness. I returned home to a happy dog (Grandma spoils her), but I noticed the lump was larger. It was going to be a hectic week because I would only have about two days at work before I traveled to Boston for a veterinary convention. I took Shalane into my clinic and submitted some aspirates of the lump to be reviewed by a pathologist. Like many aspirates, they came back inconclusive. Luckily, I do not have a shortage of fabulous and brilliant friends. I texted a good friend of mine, Dr. Jackie Pearce, a veterinary ophthalmologist (eye ball doctor as my husband likes to say) at the University of Missouri College of Veterinary Medicine (my alma mater). She agreed to fit her into her busy schedule. I had to fly to Boston the next day, but luckily my husband could take Shalane to her appointment. I was able to talk with Dr. Pearce in between my flights and layovers to Boston. She noted that cancer was a possibility, and they would like to take a biopsy. Cancer. When this first popped up, like many veterinarians, I’m trained to make a list of differential diagnoses (possibilities) in my head. Cancer was, of course, on my list, but it was definitely at the bottom. I enjoyed my veterinary convention, but spent a lot of my time in Boston feeling guilty that I wasn’t there for my pet. Had I not been so busy with vacation and this darn convention, would I have caught this sooner? It’s a running “joke” that veterinarians are often so preoccupied and busy taking care of their clients’ pets, that their own pets get put on the back burner. I arrived home, and a few days later the pathology report arrived. Shalane had a high grade soft tissue sarcoma. This particular type of cancer can be locally invasive and needs to be treated aggressively. Not that I’m biased or anything, but I’m convinced that my alma mater is the best veterinary school in the country. I am fortunate to live within 30 miles of it. We took Shalane back to the MU teaching hospital for a CT, oncology consult, and surgery consult. The good news was that the tumor was isolated to her lower eyelid and hadn’t spread. The bad news was that to remove as much of it as possible, Shalane would also have to lose her eye. I was at ease with this, however. Many of my canine patients were one-eyed dogs, and they seemed to adapt well and get along just fine. As a veterinarian myself, I perform a lot of surgery. However, this was a somewhat complicated tumor, and a bone in her face may have to be removed. The fact that she was my own dog also complicated things. We made the decision to leave her care in the capable hands of the MU teaching hospital and have her surgery performed there. Dr. Mann, veterinary surgeon extraordinaire, would perform the surgery. Dr. Mann was the patient professor who walked me through my very first spay during veterinary school, so I knew Shalane would be in very capable hands. Dr. Mann did a beautiful job on the surgery, and the pathology report came back with clean margins. Great news! This was an aggressive tumor, but they got all of it, and hopefully Shalane could go on to live a happy and healthy life. I was on cloud nine. However, life has a way of bringing you back to reality. After discussing Shalane’s case with Dr. Selting, an esteemed veterinary oncologist, I was made painfully aware that the mean survival time after a tumor like this is just over 500 days. 500 days. You mean I could have less than two years with my dog, even after they got all the cancer? The other sad news was that since Shalane was younger, the situation was more dire. These tumors are often more aggressive in younger dogs. I remained hopeful that the cancer wouldn’t return, but I would remain diligent by monitoring the surgery site carefully and taking chest x-rays (in case the cancer had spread) every three months. Shalane recovered wonderfully from her surgery and went back to being a happy, healthy dog within a few days. However, after losing her eye, she was a bit more irritable with our cat, Linus. She wouldn’t attack him by any means, but she would growl and bark at him frequently. Perhaps she thought the cat scratched out her eye in her sleep? Cats are evil like that. Fast forward about two and half months. My husband and I were winding down for the evening, watching reruns of The Office. I looked over at Shalane and saw a bump on her muzzle. No. It can’t be. After further inspection, I realized the tumor had returned. The veterinarian in me knew the statistics of this tumor and that recurrence was likely, but the optimist in me couldn’t believe it. For the first time in years, I had decided to be in a play with the local community theater. I figured it didn’t hurt for me to use the right side of my brain for once. Between work and my play rehearsals, most nights I wasn’t getting home until about 9:30 P.M. If I hadn’t been so preoccupied with work and play practice, would I have caught this sooner? Here comes the guilt again. I cried myself to sleep that night and got very little rest. The most important thing an owner of a pet with cancer can do is consult your veterinarian and let them council you. They can lay out all of the options for you, ranging from the gold standard, most advanced treatments to just keeping your pet comfortable for as long as you can. The hardest part about this process is that there is no “right” or “wrong” answer. Ultimately, only you can decide what is right for you and your pet. Your veterinarian just gives you the tools to make that decision. You not only have to consider the cost of treatment, but the time you spend with each treatment route and how that treatment could affect the bond between you and your pet. If your pet runs and hides from you or tries to bite you every time you give a medication, then some treatment options aren’t going to work for you. We made the decision to move forward with palliative radiation treatments and some medications given at home. My work schedule made shuttling Shalane to the MU veterinary school twice weekly difficult, but luckily I have a very supportive husband and family that were willing to make that process easier. Being a veterinarian can help in a lot of ways with this process. I am able to understand the pros and cons of different treatments a little better, and I have a lot of resources to help my pet through this process. However, being a veterinarian doesn’t make you immune to the guilt and emotions you go through when your pet has cancer. I am left with the harsh reality that despite investing years and years into my education (not to mention thousands upon thousands of dollars in student debt), Shalane will in all likelihood eventually succumb to her cancer and there’s nothing I can do about that. No matter how late I stay up reading scientific journals about soft tissue sarcomas, no matter how much money I invest in her treatment, no matter how many hours I spend giving medications and nursing her to health, her cancer in particular is incurable and no pet lives forever. The best I can do is live in the present and enjoy her while she has a good quality of life. Shalane is still as spunky as ever. She terrorizes possums, and she would bark at coyotes all night if we let her (as a Great Pyrenees, she feels this is her purpose in life). We have her excellent oncology team at the University of Missouri to thank for that. Thank you, Dr. Selting, Dr. Pearce, Dr. Mann, and all the students and team members that have helped make this process easier. I can’t imagine going through this with anyone else. I guess the take-home lesson and most important thing for pet owners with cancer (and pet owners in general) to remember is to love your pet, this day and every day. Whether you’re shuttling your pet back and forth for advanced treatment or just keeping them comfortable, just enjoy them and love them as much as you can. You never truly know how much time you have left with them.
2 Comments
Rebecca Galloway
12/14/2015 09:04:20 am
Thank you for sharing. Prayers for peaceful, playful and pain free days!
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Sonya
12/15/2015 06:57:51 am
I read this right before I left work, then Glory be, saw Shalane out for her morning walk. You're in my thoughts and prayers, I pray the best for your pup.
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Jessica Stroupe, DVM
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August 2017
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