What a wild two weeks it has been.
We met with the oncologist on Wednesday — we shall henceforth call her Dr. Sparkles for her excellent choice in shoes.
Previously shared but worth seeing again.
Dr. Sparkles confirmed we really do not know the type of sarcoma in Sparkle’s leg. The nature of the lung mass is also not definitive. Samples (slides) have been sent to Vidium, as I previously shared.
So we are waiting for those results, which may or may not offer definitive diagnoses.
Dr. Sparkles and I discussed options. There is no option that is curative — that is important to understand. Whatever this leg thing is will most certainly be the cause of Sparkle’s death 💔
Sarcomas in bones are very painful.
Note how Sparkle holds up that leg.
Some might elect to euthanize a dog at this point. Sparkle clearly has a painful leg. For the human, it is emotionally hard and expensive to manage a dog who is three-legged due to sarcoma pain. Those things might combine to create a situation whereby euthanasia feels like the least bad choice.
That is not how I roll.
We could amputate Sparkle’s leg. That would eliminate the sarcoma pain. Yes, there would be surgery recovery pain but it would pass and she could just hop through the rest of her life. What the heck — she is three-legged now. It would also eliminate the risk of a pathological fracture in that weakened bone.
Amputation is not curative. Whatever this is has certainly already started to move through her body. We also have the reality that she has something else in her lung. Prognosis with amputation (plus chemo) is about six months. That would get her to her 12th birthday.
Yes, she is closing in on 12 and while older age is no reason to abandon ship, so to speak, it is most certainly a factor in the decision-making.
Enjoying normal life 🩷
Amputation also offers a path to clear diagnosis because a real biopsy can be done as opposed to needle samples on slides. Diagnosis would offer clarity about whether chemotherapy would be an option and if so, which protocol would be most effective.
All important considerations worth considering but my answer is no to amputation. It fails the Benefit/Burden Test. Too much burden on Sparkle and not enough benefit.
Chemotherapy? We would need a better sense of her diagnosis before that could be evaluated. Some chemo can indeed be palliative (aka symptom management) and life extending but the side effects need to be plugged into the Benefit/Burden Test. Right now, chemo is not even on the menu due to a lack of diagnosis.
Palliative radiation is another option. That is not available here but we could easily travel to a place that does it. I want to talk more with Dr. Sparkles about this. I do not have enough information to know how to think about this.
Bisphosphonates are used in humans to treat osteoporosis and they are also used for dogs who have bone cancer with the goals of reducing pain and strengthening the bone. There are minimal side effects. It is given once a month, requires an IV, and takes about 20 or so minutes to administer. This treatment passed the Benefit/Burdens Test, and Sparkle received it on Wednesday.
Dr. Sparkles and I also reviewed Sparkle’s meds — pain management is primary. We also discussed the need to avoid a pathological fracture by managing the environment and Sparkle’s activities — if she breaks that bone, Sparkle will need to leave immediately 🌈💔
Life does not have to be perfect in order to be worth living — that is important to remember. Sparkle is still doing her sparkling things. She seeks attention, wags her tail, eats, and is happy to practice her special pick-up skills.
Yes, Sparkle has pain. She knows how to use her body to mitigate it, and we have a good pain management plan that is working for her. Sparkle is alert and happy — and herself.
And so we will carefully and thoughtfully stay the course — whatever that turns out to be 🩷 She is worth it.
Please have a sparkling day — you are worth it ❤️