A CT Scan That’s Left Us With So Much Unkown

As we arrived at the University of Guelph, Ontario Veterinary College, Cancer Centre, we were both exhausted.  If coffee was available via IV I would have hooked myself up and been entirely okay walking around with a leash in one hand and a coffee drip in the other.

Beauford had seemed in decent spirits on the way to the clinic, and given that this wasn’t his first time at the OVC he knew exactly where were we going, and even stopped to pick up a stick along the way.  Despite being tired he still finds happiness in the littlest of things.  A lesson which I absorb now daily, hoping to always carry it forward.

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We walked into the cancer centre and a flood of comfort came over me.  I looked up at the wall and saw a portrait of a treasured family friend’s Golden, Tucker.  Seeing Tucker’s face I felt instantly at ease, knowing that Beauford had someone special watching over him.

You see, because of Beauford’s condition he was at higher risk for the anesthesia.  I had fought the fears that he might not wake up, or would wake up with complications, in the days leading up to this appointment.  Once I saw Tucker it’s like I knew that Beauford was going to make it through this.  He had one of his very first buddies there, in spirit, who’d give him the strength and guidance he would need to be okay.

As we walked over to the portrait I decided to document this moment, and took a picture of a pair of two old friends.

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The first person we met was a student named, Sarah.  I offered apologies for being tired, and warned her I might get teary.  I explained that I hadn’t slept much since the mass was found on his ultra sound.

As we went through Beauford’s extensive medical history, and reviewed his  current diet, vitamin supplements, and medications, I realized just how much knowledge I keep stored in my brain.  It’s no wonder I get up to get something from the kitchen, and in the mere seconds it takes me to get there I have forgotten what I went in for.

Here’s one lesson I’ve learned as Beauford’s mother.  Having a dog with special needs means sacrifice, but for every sacrifice you find new strength, new talents and abilities you didn’t know you had.

Then we met “oncology” a team led by Dr. Woods who has a fantastic supportive manner with his patients both animal and human.  You see I feel like a patient too.  I am the person responsible for understanding and retaining the information I’ve been told, and making all the difficult decisions.  They advised they were mostly certain that the mass Beauford has is cancer, but there was a slight possibility that it might not be.  It was a glimmer of hope that for some might have lit up their souls, but since my gut has known for some time that my monkey (Beauford’s nickname) was sick, it did little for me.

The mass could not be biopsied.  The risk of complications far too high.  Had they tried, he would likely die.  So, the face of the beast, the name of the beast, might never be known.

I was very clear with everyone that Beauford’s best interests were what mattered to me.  I wasn’t the patient that was going to tell them to do whatever they could to save him if it meant him feeling pain.  I told them that I would rather bear the unspeakable agony of him not being with me, than him having to undergo complicated and complex surgeries, or treatments that would leave him feeling unwell and no clear idea of survival time.  I wasn’t going to keep him alive, for me.

Beauford’s CT scan was scheduled for 1:30 that afternoon, and he was going to meet with the anesthesia team to be certain that extra care and attention was taken with the tubing.

Dr. Woods and Dr. Safi were both incredible.  Knowing that he was in such capable and kind hands I signed the papers, with all the warnings,  knowing all the risks, without much hesitation and anxiety.  I gave myself five bonus points for being able to kiss Beauford and leave that clinic without crying.

That day was LONG.   I worked at the hotel, but nothing could distract my mind from knowing that my golden child was under anesthesia, and that within hours I would hear what I already knew, that Beauford has cancer.

As I walked to pick him up from the clinic that evening, the storm had started.  The roads went from being calm and clear to snow covered and dangerous.   I couldn’t have written the irony better.

I met with the team.   The mass that had been seen on the ultra sound was confirmed by the CT scan.  It was made clear to me that the mass was actually on the adrenal gland.   It was likely cancer, but there was no way without removing it to know exactly what kind. Basically the CT scan exposed a lot of unknown, and left us with more questions than answers.

I am no scientist, so I have to explain things is the lamest of terms.   The tumor he has could be an Adrenal Pheochomocytoma or an Adrenocortical carcinoma.  Without a biopsy there is no way of knowing what kind of mass this is.  And the only way to biopsy would be to surgically remove it.

There is so much unknown, a giant box of unknown.  The only certainty with cancers like these are that they  will inevitably spread.   This mass could invade the surrounding vessel, it could affect his blood pressure causing episodes of collapse, or it could stay small and just spread.

I asked the question any pet parent would ask.   How much time do I have left with him?

With surgery or without, still there is no definitive answer.  It could be months, it could be years.  They may remove the tumor and find that he needs chemotherapy or radiation, or he may not.

There were two options presented to me.  Surgery, or let him live out his remaining days, with regular ultra sounds to monitor the mass.  I was left to take him back to the hotel and think, with an appointment scheduled to see the surgical resident the following morning at 9:00 a.m.

A cab picked us up from the clinic.  And thankfully the cab driver was AMAZING.  So sweet, so kind and offered me words of encouragement, and complimented Beauford on his nature and disposition.

The snow was raging, and Beauford was unsteady on his feet, whimpering with confusion – a side effect of the anesthesia.  When we got back to the hotel my little piggo ate.  That’s the only thing he knew how to do was eat.  He struggled with laying down, and standing comfortably.  His surroundings, not home, were confusing.  Everything confused him.  His cries ripped at my heart, and I am not kidding, stabbed my soul.

It was a heartbreaking evening, filled me me calling the emerg service to make sure Beauford’s behaviour was normal.  I ended up placing a sheet on the hotel carpet, with a pillow and wrapping myself around him, hugging him, and singing to him.  It was the only thing that would settle him for a few moments.  I let him feel my heartbeat, enveloped him with as much love as possible.  I can’t adequately describe how brutal that night was.  He was scared, and he was unsure, and to top it all off he started to have the trots at midnight.  So, there I was, alone, in Guelph, outside of a hotel, in a blizzard, with a dog that couldn’t quite figure out how to poop yet.

Here’s a tip — a big one — don’t go to these appointments a lone if you don’t have to. You need another set of ears, and a comforting hug when you’re dealing with the after effects of the anesthetic.  SO much information is relayed to you, and your heart hears it, your ears don’t process and relay every message to the brain.

After a 3rd completely sleepless night for me, Beauford finally started to be “normal” at 7 that morning.  We left for the clinic to meet the surgeon.  Beauford hesitated several times as we trudged through the snow on the way (a message that didn’t escape me) and I assured him I was not leaving him there.  We were armed with Roosty (in my purse) since I was told what I already knew, that stuffed guy is his security blanket.  They knew he would feel safer if it was there with him.

We met with the surgical resident.  She was also amazingly kind, and patient and gave me LOTS of additional information to process.  What’s known is what we have a slim window to remove the tumor laparoscopically (ph) given it’s size.   The risks and recovering time are high and long, but the laparoscopic approach is better than waiting and going in later, which means a more invasive surgery.

I believe they told me that the risks were as high as 20% chance Beauford might not make it through the surgery.  That’s a high number.

Ultimately, Beauford couldn’t get the surgery right away anyway, even if that’s what I decided.  Given that it could be an AP tumor he would need 2 weeks of medications to stabilize his blood pressure and reduce the risks associated with the surgery.  So, basically I had time.  Time to process, time to think.  I left the appointment armed with journal articles and not the foggiest clue what to do.

We did do a special urine test – one that had to be sent to a lab in the States – in efforts to determine if the tumor is AP or AC.   Results will come back in 2-3 weeks.

I left Guelph with more questions than answers, through no fault of their own, and began this leg of the journey committed to my vow to put Beauford’s needs first.

 

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