“In Retrospect”. This Has Now Become A Very Uncertain Journey

Beauford has never been a typical case.   Since he’s been a puppy he’s always been a bit of a medical enigma.  He’s been diagnosed and misdiagnosed, and if I had a dollar for every time I heard “we’re not quite sure”, or “I don’t know what to tell you” after a medical procedure or blood test I’d be rich!!!

I was told when he was 6 months by a bright minded specialist that there was something wrong with him, but they couldn’t pinpoint what, and that he likely wouldn’t make it passed age 1.  I refused to believe that, instead walked out of that downtown specialty clinic committed to giving Beauford the best life.   Though I am not perfect, and I have made mistakes, I have certainly tried to live up to that promise.  Now, he’s six and I find myself feeling the same was I did as when he was six months.

I write this with the understanding that the news from yesterday is still fresh, shrouded in uncertainty, and not having fully processed everything.   It’s now believed that Beauford does not have a mass on his adrenal gland as first thought, and there is some variability in his diagnosis.

When Beauford was first “diagnosed” the radiologist saw on the ultrasound what he believed to be a tumor near Beauford’s kidney.  The prognosis he shared with our family veterinarian was not good.  He had seen this before, and didn’t believe anything could be done to save him.  Second and third opinions were sought as to what, if anything could be done, for Beauford.

In the emotional hours following Beauford’s diagnosis I remember very distinctly standing in Pet Valu getting the call saying that all hope might not be lost.  Apparently the VEC in Toronto and the OVC in Guelph believed something could be done.  There was mention of an MRI, CT Scan, repeat diagnostics.   VEC said their plan was to do an MRI , Guelph said their plan was to do a CT Scan.

Given that Beauford had an extensive medical history in Guelph, was comfortable there in their care, that it has a remarkable canine cancer centre, and was most reasonable in terms of cost, I chose to go to Guelph.

After Beauford’s CT scan I was told that they believed him to have an adrenal mass that was either the AP or AC tumor.  I was also told that Beauford’s adrenal gland did not light up in the way they had anticipated (not shocking, it’s Beauford) and because the mass was too high risk to biopsy, the best diagnostic tool to find the type of beast was surgery.

I went with my gut, and decided against the surgery.   Instead we did the – for lack of a better term  – fancy urine test to see if this was an AP mass.  I opted out of surgery. We got the results of that test back and it didn’t appear to be a blood pressure tumor.  So, that was “excellent news”.  Instead it was decided to test for Cushings, and the oncology team was now more comfortable with my choice to monitor the mass by way of ultrasound to track its growth.   I made that choice against surgery because I believed it was the absolute best choice for Beauford.  I have never been more thankful that I did.

Beauford OVC

Beauford had his one month follow up yesterday.  As we traveled to Guelph I was nervous, but hopeful we’d hear that the mass was the same size, and there was no sign of it spreading or threatening surrounding organs.  We stopped at Ren’s Pet Depot on the way and he displayed epic poor manners when out of sheer excitement he knocked over an entire urn like display of gigantic beef sticks.  He was the very definition of a bull in a china shop and I was the jerk owner that found it amusing since it was great to see him have his second real enthusiastic burst of energy this week.

After speaking to the student in oncology, I was advised that he might have to be mildly sedated for the ultrasound.  I hoped he’d be able to get through it without it, since he has never required it in the past, and I remember all too well how hard it is for Beauford to metabolize and process sedation.   Unfortunately, Beauford had to be sedated as he was uncomfortable during the procedure.

When we came to pick him up I was told that he might require a second ultrasound, and there was some talk of a biopsy.   This ultrasound was clearer than the previous CT scan, and there was some doubt, or perhaps some clarity, offered by what they found yesterday.  I was confused since I’d be told a biopsy wasn’t possible because the risk of complications was too high.

I met with oncologist, and I was told that the ultrasound image yesterday was indeed actually clearer than that seen from the CT scan.  According to yesterday’s imaging, it does not appear that Beauford has a mass on the adrenal gland.  And what they believed was a mass causing the surrounding lymph node to swell, is now thought to be a very swollen lymph gland.

I am obviously frustrated, upset, confused, and have tons of questions.  Questions that unfortunately there are no concise answers for.  I was told that “in retrospect” an MRI would have been a better diagnostic tool.

So, what does all this mean?  Here’s the thing, I don’t know.  There was some discussion that it could be three things…

  1.  That this particular lymphatic gland has always been enlarged that way — NOT LIKELY though since he has had ultrasounds in the past and it wasn’t ever seen before.
  2. Beauford has some kind of infection, though it’s uncertain what it could be.  Nothing has showed up in his extensive bloodwork, or other diagnostics that would give them any tip off as to what it could be.
  3. This enlarged lymph node is a cancerous lesion.   There may or may not be other cancerous lesions elsewhere at the moment.   Thus, we’d now be dealing with a different kind of cancer altogether, lymphoma.

 

The biopsy that was briefly discussed in the waiting room, was discussed further in the exam room.  It would still be high risk because the node is still close to the vessel, and Beauford would require further, deeper sedation, to ensure they would be able to get a good sample of the node.

Beauford was in the room the entire time with us (and Roosty) and he was struggling from the side effects of the sedation.  He was whimpering, crying, panting, unsteady on his feet, anxious, and at one point his back legs just gave out suddenly and he stumbled into the cabinetry. His tail was stuffed so far between his legs, and his eyes were tired.   This guy, was not my smiling golden guy.  My heart hurt and his eyes said it all.  He was over it, and so am I.

So, now what?  We have no definitive diagnosis.   We are facing an uncertain beast.    I have listened to my gut from day one.  I have had Beauford’s best interests in my head, and in my heart, every single step of the way.   Trusting myself, trusting my bond with Beauford, and listening to my gut has not led me astray thus far; so, I will continue to do that.

Last night was terrible.  I slept for an hour.  Beauford came home and was resistant to eating, remained slightly unsteady on his feet, and  unless he could feel me next to him he would whimper and cry.  I sat next to him on the wood floor for hours.  I should have done creative mattress movement (my bed is too high for him to get in and out of in that state safely), but I was physically and emotionally exhausted, and figured sitting with him, his head on my leg was just as good as anything.

This morning at 6:00 a.m., my smiling golden guy woke up!   The side effects from the sedative finally wore off, and despite my absolute exhaustion we were at Pet Valu this morning so Beauford could get a new bone to chew.  And this time, I let him bring it home. He’s already decided that it’s acceptable to proudly display his treat and bring gross bone in the bed.  Yeah, cancer or no cancer gross beef bone in my bed isn’t happening!   So, we had a little discussion about that today.

As for the future, at this moment it’s been decided that Beauford will not be returning for further diagnostics, or follow up until July at which time he is scheduled have an ultrasound of his entire abdomen, not just his adrenal gland.

The sad reality is that if this lesion is lymphatic cancer, it will undoubtedly spread, and unfortunately the ugly face of cancer will begin to appear by way of reduced appetite, vomiting, gastrointestinal issues, increased lethargy, and coughing.  Lymphoma though “treatable” is not curable.

There is absolutely nothing pleasant about that.  Not a single damn thing.

So, do I need to go back next month have Beauford sedated to see if it’s spread?   No.   Beauford seems to struggle greatly with the side effects of sedation.   Given that he is uncomfortable during ultrasounds to have many would become unpleasant for him, and would mean too many nights like last night.   To me, (and to him I’m sure) the short term pain doesn’t provide long term gain.   Three months seems to be a fair compromise; so, I don’t need to go back monthly to check.  If this is lymphoma without a doubt in time we will know.

What I need to do, and what I am absolutely committed to, is doing what  have been doing since “diagnosis day” and that is making each and every day special.

Beauford glasses

 

 

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