Cancer

Hi everyone,
Along with my Cav Maggie, I have a 12-year-old Brittany spaniel named Behr. He's been such a dear friend to me for so long.

I just learned that he has cancer at least of the spleen, but there are tumors also on his liver. They want to go in and remove the spleen and do a liver biopsy. They think he's a good candidate, he's in awesome shape. They are doing a full blood work-up first to ensure there are no other health issues in play, if that comes back clear they want to go ahead with the surgery.

I hate to think of money at a time like this, but the surgery will cost close to $2000. The spleen removal will prolong his life they say, but will not cure him. And if there are cancerous cells on his liver, then it will all be for naught.

One thing I have noticed recently is he has become ravenous. He was never a food motivated dog. He used to self-feed...I'd just have a bowl of kibble sitting out and he'd eat when he was hungry. Now, he scarfs down whatever I put out. He hasn't put on any weight, in fact, he's on the thin side.

I had to fast him for 12 hours before his tests this morning and he was really upset when feeding time passed and I didn't put out his bowl. He started growling and barking - he's never done that before. Anybody have any experience with this?

He also seems to be really thirsty and urinates a lot more frequently.

Please pray for my sweet boy. I'm beside myself with sadness.

Hope everthing goes alright I will be thinking of you both
----Aileen and the gang (Barney---Jazzie---Sam)

I'm so sorry to hear of Behr's illness. It is really hard when you've had a companion so long, and also to know they are ill and may be uncomfortable or in pain. :flwr:

You are also facing a difficult decision and it is perfectly fair to be considering costs as well as other elements. I'd also be weighing up how much time he would be likely to get from the surgery, assuming all else looks good. Then you need to weigh that against the stress you believe he may go through for the surgery, how important that extra time may be to you, and again, if it is worth the cost. How long are they talking about when they say 'prolong'? What will quality of life be like without the spleen, and how long will recovery take? How long would Behr likely have without the surgery? Are their medications that would keep him comfortable for any length of time?

I note from some websites that the average lifespan is 12-14 years. Of course that is the average and some dogs would surpass that 14.

Remember the decision is yours, based on many different considerations. Just because you CAN do something doesn't mean it is always what you SHOULD do or MUST do, and vets can sometimes try to push a decision towards what CAN be done. You are talking about something that is highly personal and I would want the best answers the vets could give to all the various considerations, and then compare the different possible scenarios:

* successful surgery, no problems with liver
* succesful surgery, problems with liver
* no surgery, palliative care

... likely time you'd have with Behr with each, costs of each, stress on Behr of each, quality of life in each case, and so on.

Just don't feel guilty -- there are at least three RIGHT decisions depending on how you weigh up the considerations, risks, possibilities, downsides, costs, your risk and comfort level, your philosophy, what seems right for Behr.

With dogs that have syringomyelia and knowing many others in that situation, I do truly understand how difficult such a decision can be as well as the fact that there are clear unknowns that could affect the outcome. You need to do what you think is right after a careful consideration. :flwr:

I am keeping you in my thoughts.

With our rescue Julie being 13.5, I know the time will come, possibly sooner than later, when I will have to make some of those tough decisions myself.

I'm sure you'll make the best decision you can for Behr & considering your other circumstances and I think Karlin gave you some great advice.

Good luck :hug:

Karlin said:

How long are they talking about when they say 'prolong'? What will quality of life be like without the spleen, and how long will recovery take? How long would Behr likely have without the surgery? Are their medications that would keep him comfortable for any length of time?

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Hi Karlin,
Thanks for your thoughts...
Basically, if I don't opt for the surgery, then the spleen will eventually rupture and Behr will bleed to death internally - prognosis...four months or less. (I am crying as I type this...I can't imagine what that would be like!)

If I do opt for the surgery and remove the spleen, he will still die of cancer, and the cancer typically associated with the spleen is very aggressive. But at least he won't bleed to death - prognosis...up to a year.

There are no medications that will prevent a bleed, unfortunately.

Oh Chardonnay, I am so sorry that Behr is sick and that you have such a tough decision to make. Just know that you & Behr are in my thoughts & prayers. :hug:

I thought EVERYTHING that Karlin said was perfect including "don't feel guilty" about the choice you have to make. I think Behr knows that you love him and he trusts that you will do what you think to be best for him.

My heart aches for you knowing how tough this is.

Chardonnay, I'm so very sorry that you are faced with all of this my heart aches for you :cry*ing: please know that you and Behr are in my thoughts and prayers :hug: :hug:

What a rough place to be in. I know you will do whatever is right for both you and for Behr. Sending warm thoughts your way and lots of hugs.

That's a very tough decision.

I think if it were my dog, at that age, my inclination would be to really enjoy my time with him for a month or two, then to let him go. :flwr: If there's a likelihood of being able to spot a decline that comes in advance of a rupture, then I'd likely manage my dog until that sign and then let him go.

I don't say that to argue that any one choice is right or wrong. You will need to make a choice, and there will be consequences that right now you cannot know or determine, and only in restrospect might you know if you made the right decision. You might never know -- feeling regret for one choice, or guilt. None of the choices is easy, and all have a range of pros and cons.

But I would probably make the choice to not put a dog of his age through a complicated surgery (as this would seem to be, at that cost) to gain at most a year, perhaps much less. The cost would be part of it; but even if I had insurance, I'd likely make the same decision. But that is MY scale for weighing thing up. You and many others might well view things very differently and that would be just as right a point of view.

Sometimes I think it helps to try and consider what you would want, in the same position. Behr's age would be similar to someone in their 80s or so. Would you welcome a surgical intervention for a bit of extra time, in the context of the surety of another terminal illness around the corner? Some would, and some wouldn't.

You will make the right decision for you and for Behr.

Hi Chardonnay!

I am so very sorry to hear of Behr's illness and the decision you are faced with, you are in my thoughts :hug: :flwr:

Thanks everyone for all your kinds words and your concern. It means a lot.

I don't get it. Behr was in a terrible car accident recently that claimed the life of my stepson and the fact that he survived was a bit of a miracle and some comfort for our loss.

But for him to end up with cancer six months later hardly seems fair. Maybe his best friend is calling him home...

I'm so sorry this is happening to you and Behr.:hug::hug:

My sister had a sweet, 7 year old flat coated retriever rescue boy who had a similar problem. He suddenly became ill, and their regular vet felt that Sparky probably had liver and spleen cancer. The vet referred my sister to a full service animal hospital, where they told her the sad news that he was internally bleeding. The emergency vet offered to do surgery to remove his spleen, but explained that Sparky most likely had liver cancer as well. My sister opted to give him his wings that day, and he fell asleep with his head on her lap. I felt it was the right thing to do and would have done the same.

I don't know what his symptoms were, but I will ask her. :flwr:

Cathy Moon said:

The vet referred my sister to a full service animal hospital, where they told her the sad news that he was internally bleeding. The emergency vet offered to do surgery to remove his spleen, but explained that Sparky most likely had liver cancer as well.

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Yes, the type of cancer mostly commonly associated with the spleen is hemangiosarcoma and is a highly metastatic. By the time they rupture it is truly too late. That was the best choice for your sister.

We are fortunate to have detected the tumours in Behr while they are still small, but spreading. That said, prognosis is poor no matter what we do...the difference of a few weeks or months to a few months maybe a year as it is very aggressive. The likelihood that it is not already in his liver is small, especially since masses have been detected there by the ultrasound.

The thing is he's not showing any signs of illness at the moment. The food thing the vet says is totally unconnected.

Your vet is probably right about the food thing, but possibly it could be "tumor wasting" cachexia; people who have metastatic/fast-growing tumors often exhibit weight loss, night sweats and fever/malaise("B symptoms"). As a result, he may be more ravenous than usual.

Chardonnay, your post just breaks my heart. Please know our thoughts are with you and Behr at this difficult time. We know that the decision you make will be the right one for you and him. :hug: -Natalie and Mike

Hello Chardonnay

I am so sorry to hear about Behr. I so agree with what Karllin & many other have said about the decision making process. Weighing up all those factors eg how much extra time will surgery buy, how much discomfort or distress will be caused to both Behr & you & your family, and yes also the cost involved. We don't like having to face that crunch time re the cost, but the reality is there that there is a limit to how much we can afford to extend the life of our dogletts.

It is such a difficult place to be and my heart goes out to all of you. :flwr:

I am so sorry that your stepson passed away. My heart broke for you when I read your post about Behr, and now to find out about the accident.....it's totally unfair....completely heart wrenching. Please know that I'm thinking about you and sending you my prayers.

Hi everyone,
Again, thanks for all the kind words and your compassion. The vet and I agreed yesterday to put off making any decision regarding the surgery for four weeks. She will conduct another ultrasound at that time to see how fast the masses on his spleen are growing and if there are any changes to his liver, which also have lesions, but which haven't changed from the previous ultrasound. I am going away for a few days twice this month so I wouldn't have wanted to have the surgery done before that as I want to be with him.

My husband and I decided we will go through with the surgery not so much as a life-saving effort, but because we don't the spleen to rupture and cause internal bleeding. As I understand it that is not at all pleasant and is very distressing for a dog.

I will keep everyone posted on Bear's prognosis and progress.

Chard

We'll be thinking of you and Behr. :hug: