Facing loss again

Posted by: Cathy Posts: 9 - Joined: Mon Oct 26th, 2015 08:11 pm

#922 - by Cathy >> Mon Oct 26th, 2015 08:51 pm

Hello, I found your site when searching elsewhere and am so touched by the stories and messages of support. My story is a little different to the ones I have read, but I’m hoping it’s not out of place to post it on here and ask if anyone else has been through what I’m currently experiencing.
Just over two years ago we had a message from my niece asking if we could re-home her little dog Bertie, a JRT-border collie X . At the time she was a single mum of two lively little boys, both under 6, and she had come to the sad (but sensible) realisation that she couldn’t give Bertie the time and attention he needed. She herself was his second owner (that she was aware of), and had had him around three years. As we’d been talking seriously about getting a rescue dog, we agreed that we’d take him on – although we did wonder what we were getting into. Did he have serious behavioural issues that meant he was onto his third owners in his eight years of life? How would our two cats cope with a new doggie presence? Were we up to the challenge? Well, we shouldn’t have worried. He is a brilliant little dog, so friendly, affectionate, responsive and gentle, and fit and healthy. We assumed we’d have him for several years and he has made our home complete.
Then a couple of weeks ago we took him to the vet’s for a routine dental as his breath had become rather stinky – his only visit to the vet’s outside of going for his annual vaccinations. The vet noticed he had a smallish lump inside his mouth which he thought was an abscess, and assured us it would be sorted during the dental. When we went to collect him later that day the vet said it wasn’t an abscess after all, but a lump inside his cheek – and there was another on his neck. He had taken needle aspirations to send off to the path lab ‘just in case’. When the results came back a few days later they indicated cancerous cells; Bertie went back two days later for proper biopsies on the lumps. By this stage we were beginning to have that old familiar feeling of dread.
Well. Bertie has T-cell lymphoma. The worst kind, which doesn’t respond well to the chemotherapy prescribed for the more common B-cell type. The results have been sent to a veterinarian oncologist for his report, treatment suggestions and prognosis and we are currently awaiting that report. But it’s not looking good – it seems the best we can hope for is ‘palliative care’ which might extend his life for a few weeks or possibly months if we’re lucky. So we are currently attempting to keep things as normal as possible until we get that report and make those decisions, and brace ourselves for the inevitable decision at the inevitable end…
It all seems so unfair, and so unbelievable. Our little dog, on the face of it, is exactly the same as normal – enjoying his food, his walks, his cuddles and his toys just as much as ever. He simply doesn’t SEEM ill (although that’s not to say we doubt the test results). On his walk just this afternoon he was charging about with his little coat on, having the most splendid time, and then came back and wolfed down his dinner. He’s not lost any weight. His coat is shiny and soft and his nose is wet and black. It almost breaks my heart to look at him and know we won’t have him for much longer, but not knowing how much longer… I lost my last beloved dog, a beautiful golden retriever, to cancer five years ago – an aggressive osteosarcoma that was discovered when he went for a routine X-ray to discover why his arthritis had suddenly worsened despite being on medication – and two days later we had him put to sleep as the cancer was everywhere and inoperable. He too was only 10 and my ex and I had had him from 9 weeks old, and the pain of losing him was dreadful. I never thought I’d have to face losing my next dog to the very same filthy, pitiless disease.
There is, of course, the slightly comforting fact that we know what the inevitable is, and we can make sure we make the most of whatever time we have left together – a luxury we don’t often get with our pets, and certainly not one I’ve ever had with any of my others down the years. But it brings its own pain, and I’m not handling it very well. I’m trying hard not to be sentimental, but just looking at him going about his usual doggie things is almost breaking my heart…
So if any of you have ever been in this situation, I would so appreciate hearing your ways of dealing with it. Thank you so much.
Posted by: Michelle Ball Posts: 66 - Joined:

#923 - by Michelle Ball >> Tue Oct 27th, 2015 03:00 am

Hello Cathy,
What a wonderful bundle of joy Bertie sounds! You describe him so well I can imagine him running around in his little coat, having lots of fun. You are providing the most loving, happy home for him, so you must always remember this...
I really empathise with your story as I had the most wonderful, unique cat called Big Fella who I very sadly had to have put to sleep in January.
He was diagnosed with chronic, and severe, kidney disease a number of months previous to this. However, at the time of his diagnosis he seemed so happy and well - basically, his usual huge, loving self. The very sad thing was I knew our time was limited, and as time passed I grieved so much despite the fact Big Fella was still with me. I think it is because we focus on the inevitable ending, and the reality of life without our beloved pet, that our hearts break with such heavy sadness. At the time, I also felt guilty that I was focussing 'on the end' so to speak, but now I understand it is all part of the grieving process, and perfectly natural.
I don't need to tell you this Cathy, but enjoy the time you have left with little Bertie, but also allow yourself to grieve. Take your remaining time with Bertie one day at a time, and allow yourself to have a good cry and 'go with the flow' of emotions. I know this approach helped me cope with the few months I had left with my beloved boy Big Fella.
Bertie sounds very much loved, and you should always remember what a wonderful home you have given him.
Best wishes
Michelle
Posted by: Cathy Posts: 9 - Joined: Mon Oct 26th, 2015 08:11 pm

#924 - by Cathy >> Tue Oct 27th, 2015 10:59 am

Thanks Michelle, and I'm so sorry to hear about your loss. Losing a much loved pet never gets any easier, does it - in fact, I honestly think it gets harder as the years pass by... It does sometimes make me wonder why we continue to put ourselves through it.
Your post helped a lot; I guess I knew I was already grieving for him, but I think I've been feeling guilty that the grief is stopping me enjoying the time we have left with him. It's as if he's already gone, yet still here. I think what's not helping is that we have no idea yet of time or treatment, and I feel frustrated that we're not able to do anything to help until we get that report. It feels a bit like we're living with a ticking time-bomb. Poor little boy.
Thanks again, it really helps to know others have gone through the same feelings. x
Posted by: Penny Hudson Posts: 155 - Joined: Tue Mar 13th, 2012 03:35 pm

#925 - by Penny Hudson >> Tue Oct 27th, 2015 05:04 pm

Hello Cathy, my first thought when I read your sad story, was bless his little heart. To have found a loving home where he could enjoy his days with you all and to be so happy, and to discover the seriousness of the vet's diagnosis just doesn't seem fair. He is obviously enjoying life and although it must be very hard for you waiting for the report you still can share such love with him. My darling cat Toffee was diagnosed with cancer 4 years ago and we had her home for a few weeks until she died. A difficult time but a time to share a special love. Love to you all; enjoy the time you have and I feel your sadness and send you loving hugs, and special cuddles for Bertie Xx
Posted by: Michelle Ball Posts: 66 - Joined:

#926 - by Michelle Ball >> Wed Oct 28th, 2015 12:57 am

Hi Cathy
You're welcome, remember to come on here anytime for heart to heart....people are very caring and supportive.
In the meantime, fingers crossed for the report, let us know how it goes.
Big hug
Michelle xx
Posted by: Cathy Posts: 9 - Joined: Mon Oct 26th, 2015 08:11 pm

#927 - by Cathy >> Thu Oct 29th, 2015 06:26 pm

Thanks Michelle and Penny, your words mean a lot.

Well the report is back from the consultant oncologist and it's not good news at all. As I've already said, the type of cancer Bertie has doesn’t respond to chemo in the same way as other tumours. The choices are quite stark:
a) Surgery to remove lump, followed by chemo when the disease returns. This option is further complicated by the fact that the lump is large and inside his mouth, and our vets’ practice is unsure at this stage whether they have the necessary experience to do it themselves, in which case Bert would need to be referred to another specialist for it.
b) Chemo starting now in the hope that this will slow down the disease’s progress. There’s a limit to how much of this a dog will tolerate; best guess is 5 sessions.
c) Do nothing and let things run their course.


Option a) would give him another 12 months at best; if our practice did the surgery it would cost around £1K, assuming everything goes according to plan & no complications. If he had to be referred it would be around £3K-£5K. Plus the cost of the chemo as & when. Option b) might give him another 6 months; the chemo sessions (depending on which protocol was used) would be c.£300 per session. Option c) … well, option c) isn’t an option at all; mainly because pain relief / palliative care for this condition is ineffective.


So there we have it. We’re struggling slightly with the dichotomy of putting him through major surgery, and all that implies, for the sake of only one more year at best, versus doing the very best we can for him. Plus of course the financial side of things… We'd love it if the cost wasn't a factor, but unfortunately it is; I am on benefits (not through choice but circumstances - my [now ex] husband walked out on me for a younger model 5 years ago after 27 years of marriage, leaving me penniless... but that's a whole other tale of woe!), and my husband has a very small pension. So we have to weigh up the potential costs alongside everything else. Not easy decisions at all.

Meantime, Bert is still as bright, happy, active and (apparently) pain- and symptom-free as ever. One thing we have definitely decided is to enjoy him & give him as much love as we can in the time we have left with him - however long that turns out to be.

Life is shite at times, isn’t it?…

Just a thought - and I'm really not clutching at straws here, we know and have accepted that Bertie's condition is terminal - does anybody know of any complementary meds/ foods/ supplements for this disease? I'm wondering if there's anything we could give him that might help with the discomfort or pain when it comes. I was very upset to discover that no conventional pain relief or steroids, etc, will be able to help... It's the thought of him suffering that's doing my head in :(

Thanks again.
Posted by: Penny Hudson Posts: 155 - Joined: Tue Mar 13th, 2012 03:35 pm

#928 - by Penny Hudson >> Thu Oct 29th, 2015 07:33 pm

Hi Cathy, my heart goes out to you and I send special hugs for dear and special little Bertie. I think that spending as much time as possible with lots of love and enjoyment is the right decision. To put the dear little boy through so much discomfort with chemo etc seems something I personally (and it is a personal feeling ) would not want to do. I have a friend in a cat group whose cat has cancer and she has been feeding her with all sorts of different foods etc and I can ask her advice or put her in touch with you if you like. Her cat has been doing very well, although of course there is not a cure. Sending you lots of love and always here for you. Life is hard and seems so unfair; keep strong and lots of hugs for you both xxxxx





Posted by: Cathy Posts: 9 - Joined: Mon Oct 26th, 2015 08:11 pm

#929 - by Cathy >> Thu Oct 29th, 2015 07:50 pm

Oh thank you Penny, that would be so kind of you. I do understand that supplements aren't a cure, or even a way of 'staying' the progression, but if there's anything we can do to help him deal with the symptoms we'd like to try. The vet wasn't very reassuring on this aspect (although he was very kind and honest generally), for example steroids & painkillers won't help which I find hard to deal with. Perhaps you could ask your friend for her advice or suggestions? I'm going to do some internet searching too.
Thanks again, this site is a great help xx
Posted by: Michelle Ball Posts: 66 - Joined:

#930 - by Michelle Ball >> Thu Oct 29th, 2015 07:53 pm

Oh Cathy, where do I start, poor you..talk about trapped between a rock and a hard place. I can only imagine what emotional agony you're going through right now :(
I can only tell you, as an outsider and someone not emotionally attached to Bertie, what I think.....
Whatever the circumstances, I believe the most important thing to consider is Bertie's happiness and well-being.
I know this probably sounds obvious, but I think most of us are so desperate to not let our beloved pets go, we do anything to prolong their lives. I certainly feel, looking back, that I should have had my gorgeous Big Fella put to sleep earlier than I did. But I couldn't let go.
You have such a difficult decision to make, but having read through your options, and taking account of finances too, perhaps you could:
Ask the surgery if you could pay monthly installments as the cost - a friend of mine was able to do this - and see what they say.
Ultimately, as much as an extra - or up to- 12 months with little Bertie sounds wonderful, is this really in Bertie's best interests, or do you honestly feel as soon as Bertie shows signs of feeling unwell/unhappy it is the kindest thing to let him go.
I think, if it was me, I would perhaps go for option A, depending on how much stress this would put Bertie through, or to be very honest with you, maybe allow nature to take it's course, and as soon as Bertie shows signs of being an unhappy little boy (and we all know when our pets aren't themselves), then the kindest and bravest decision will be to put him to sleep.
As hard as it is, try to think what is in Bertie's best interests.
Please stay in touch, we are here for you, anytime
Take care
Michelle xxx
Posted by: Admin Posts: 72 - Joined: Wed Jun 8th, 2011 01:05 am

#931 - by Admin >> Thu Oct 29th, 2015 08:13 pm

Hi Cathy,

Yes, for sure, life is shite at times.

As well as setting up and running The Ralph Site, I am a Veterinary Emergency and Critical Care specialist - so not a cancer specialist but clearly I know the details of what you are describing. However I don't like to give out any medical advice online about cases that I have not personally been involved in. What I would say is two things really:

1) Please do not feel in any way guilty about having to factor in costs. This is a massive reality for so many people and Bertie would not want you to be burdened with crippling bills after he is gone. It needs to be a consideration and you should not feel guilty about it.

2) Sometimes we find that pet carers find it valuable to have a consultation with a specialist to go over the information provided by your primary vet again and help decision-making. It may help you to speak to an Oncologist - especially in terms of your concerns about whether there are options for pain relief and whether they have found any treatments helpful. MAybe something to chat with your vets about. It sounds like your vets are doing a fantastic job at informing and discussing Bertie's situation with you.

Take care and give Bertie a kiss from me,

Shailen
The Ralph Site Admin
Posted by: Penny Hudson Posts: 155 - Joined: Tue Mar 13th, 2012 03:35 pm

#932 - by Penny Hudson >> Thu Oct 29th, 2015 08:47 pm

Hi Cathy, Reading the helpful post from Admin it sounds as if their advice is the best route to go down. I haven't contacted the lady I spoke to you about after reading this post. Take care and keep in touch. Hugs xxxxxx
Posted by: Cathy Posts: 9 - Joined: Mon Oct 26th, 2015 08:11 pm

#933 - by Cathy >> Fri Oct 30th, 2015 06:26 pm

Hello again, and thanks to all for the recent replies.

Michelle - yes, trapped between a rock and a hard place is an accurate description. We're swinging wildly between one option and another at the moment; just as we think we've decided we then think again. There are so many more questions than answers and it's so hard to know what to do for the best. But rest assured that his quality of life is the most important thing for us. We're not about to extend it artificially for our own sakes; however at the same time we want to be doing the best we can for him. The guilt is already bad (you'll doubtless know what I mean by that, it seems to afflict all caring pet owners at these times), and we don't want to be left feeling 'should we have done more for him?'. He will have to be put to sleep at some point - we do know and accept that, and unfortunately it's a decision we've both had to make several times in the past. Although it never gets any easier... The only positive thing is that my husband and I both feel exactly the same way (including the wavering with the decision-making!) - it would be unbearable if one of us felt strongly that we should do X, while the other felt Y was the best option... Your suggestion about seeing if we can spread the cost with monthly payments was a helpful one; thanks! I think that's something we'll definitely explore as at least it will stop us feeling that we're being mercenary in allowing possible costs being a factor in our decision-making.

Shailen - many thanks for your post, it was very helpful and sensible. I do understand your point about giving out medical information online. And great advice about asking the oncologist for pain relief options when the time comes. I should perhaps have explained earlier that the vet at our practice who has been handling Bertie's case, and who would perform the surgery should we decide to go down that route, is away on leave until Thursday next week (great timing but I guess the poor guy needs a holiday as much as anybody else!), so we were advised by another vet there that it won't make any difference to Bertie's prognosis to delay our decision until he's back. One thing we have decided is to make an appointment to see him next week with all our questions; we'll definitely ask him to refer back to the oncologist about the pain relief then.

Penny - I quite understand, thank you anyway! Having had a good look online about supplements, etc, it all seems a bit mumbo-jumbo-y, and probably ultimately pointless anyway...

It's all ghastly. Sigh. But in the meantime, our little boy is still (on the face of it) well and happy; we're taking comfort from that, at least.

Thanks again to you all - just typing all this stuff is therapeutic, also knowing that nobody is going to come out with the classic 'he's just a dog' line. You all understand and that means so much - the kindness of strangers. I'm rambling now. Sorry. xxx

Posted by: Penny Hudson Posts: 155 - Joined: Tue Mar 13th, 2012 03:35 pm

#934 - by Penny Hudson >> Fri Oct 30th, 2015 07:12 pm

hello Cathy, so pleased that little Bertie is still enjoying things; it's always good to talk and always here for you. Bertie is family and that's how we all think of our precious pets on here; when your vet returns from his holiday I am sure a long talk about things will help you cope with the many questions you have to ask. Thinking of you and sending love and big hugs for Bertie xxxxx
Posted by: Cathy Posts: 9 - Joined: Mon Oct 26th, 2015 08:11 pm

#935 - by Cathy >> Tue Nov 10th, 2015 09:06 pm

Hello again, well we had a consultation today with the vet who has been looking after Bertie, he and the other vet at the practice who also performs the major surgical procedures have been putting their heads together about his case and so we went to have a chat.

Bottom line is cautious optimism. Vet A took another good look inside his mouth (Bert's not vet's) and said the lump wasn't as large as he remembered and it isn't ulcerated yet, he also said there is no swelling of the lymph nodes which indicates the disease hasn't spread elsewhere yet (which would also seem to be borne out by the fact that Bert is still happy, lively, and not showing any outward signs of any other problems). They had consulted the oncologist again & also looked into chemo for this type of the cancer. It's their view that surgery to remove the lump would be the option most likely to help at this stage - no need to follow up with chemo immediately as they feel they would be able to remove the tumour completely. We asked them about post-surgery recovery and they said that as he is otherwise healthy and if all goes according to plan the chances are good that recovery time would be quite quick - basically just feeding him soft food and with antibiotics & painkillers. Of course, there is a chance that the pre-op blood tests might show that it isn't confined to the tumour in the mouth, also that the surgery might not be totally successful and/ or other complications, but this is always a risk and one has to balance everything up.

So... we have decided to go ahead with the surgery. The fact that they wouldn't be following it up with chemo afterwards was quite a deciding factor as we feel that as his quality of life is the most important thing it wouldn't be fair to put him through one procedure after another. We realise that the cancer won't go away but both vets & the oncologist felt that was this the best step to take at this point to give him the best chance and to help him be as well as possible for as long as possible. We also realised that if, after having this discussion, we opted to do nothing and let nature take its course, we'd always wonder if we shouldn't have gone down this route to give him at least a fighting chance.

So he's not out of the woods, but the woods are receding somewhat. I'm ringing Vet A on Thursday for another chat, then with luck will be able to book Bert in for the surgery early next week. I'll post updates on here, if that's ok :-) Wish us (particularly little Bertie) luck! xxx

EDIT: We also made arrangements to pay by instalments, so that's a big help too - many thanks for that suggestion.


Posted by: Penny Hudson Posts: 155 - Joined: Tue Mar 13th, 2012 03:35 pm

#936 - by Penny Hudson >> Tue Nov 10th, 2015 10:04 pm

Hello Cathy, Sending you love and hugs and keeping you all in my prayers for little Bertie's operation. Do let us know how things are going; bless him ; he sounds a little sweetie: ) x Thinking of you all, Much Love, Penny xx
Posted by: Shailen Posts: 100 - Joined:

#937 - by Shailen >> Thu Nov 12th, 2015 12:07 pm

Thanks for the update Cathy and hoping for the best possible outcome from the surgery. Take care.
Shailen (The Ralph Site founder)
Posted by: Cathy Posts: 9 - Joined: Mon Oct 26th, 2015 08:11 pm

#938 - by Cathy >> Mon Nov 16th, 2015 11:25 pm

Hello again.
Bertie is going to have his surgery to remove the tumour in his mouth first thing in the morning. Please send positive vibes. Thanks for all your supportive posts xx
Posted by: Penny Hudson Posts: 155 - Joined: Tue Mar 13th, 2012 03:35 pm

#939 - by Penny Hudson >> Tue Nov 17th, 2015 10:11 am

Hello Cathy, thinking of little Bertie today; sending you both love. Prayers for you both xxxxxx
Posted by: Cathy Posts: 9 - Joined: Mon Oct 26th, 2015 08:11 pm

#940 - by Cathy >> Wed Nov 18th, 2015 02:15 pm

Quick update on Bertie:
Not great news I'm afraid. He didn't have the surgery yesterday - once he was under the GA and they were able to examine his mouth thoroughly, they discovered that the tumour is not just inside his cheek but also on the gum margins. It couldn't be removed without major radical surgery (basically cutting part of his jaw away). So they decided not to go ahead with it.
So we're basically back to square one. It would appear that the most effective chemo for this type of tumour wouldn't be as invasive as we first thought - it would be orally administered and at three-weekly intervals. But at best it would only halt the spread of the tumour, rather than shrinking it or making it go away entirely. We're currently struggling with whether to go ahead with that , but obviously we have to make up our minds pretty quickly.
Thanks again for your lovely thoughts, it's being very helpful. I'll post again on here as things progress.
Cathy x
Posted by: Penny Hudson Posts: 155 - Joined: Tue Mar 13th, 2012 03:35 pm

#941 - by Penny Hudson >> Wed Nov 18th, 2015 03:15 pm

So sorry Cathy, was thinking of you and little Bertie. Such a shock for you; and now the decision to be made about the chemo. My heart goes out to you, and I know whatever you decide will be the kindest for dear little Bertie. How is he; is he still happy and not showing any outward signs of the cancer. You are all in my thoughts; love and hugs Xx
Posted by: Cathy Posts: 9 - Joined: Mon Oct 26th, 2015 08:11 pm

#942 - by Cathy >> Tue Nov 24th, 2015 03:27 pm

Thank you, Penny, you're really kind.
Well, we decided to go for the chemo because, on the basis of what we were told last week, it would be non-intrusive (pill form), three-weekly and with few side-effects. We took him along to the vets today for pre-treatment bloods & general screening - only to discover that the vet who deals with all the oncology patients had done more research into the particular drug, and discovered that the side-effects are common and pretty awful. Disastrously low white blood cell count, possible sepsis, bone marrow loss & potential broken limbs... Even though he would be closely monitored the upshot seemed to be that we would potentially be making things a whole lot worse, just to stave off the inevitable - and his quality of life would be pretty much zero. So it was a no-brainer - no chemo, thanks very much.

So we're back to square one - essentially, waiting to lose him. Over the few weeks since the diagnosis we've had our hopes raised twice, only to have them dashed. This is especially hard. On the plus side (if there is one), at least we feel we've done all we could for him, having explored various avenues. And - almost amazingly - he is still on the face of it as well and happy as ever, and not showing any outward signs at all. I've started giving him soft food so that eating doesn't irritate the tumour and make it ulcerate (which will eventually happen...), and hard chews and treats have been banned. Other than that it's pretty much life as normal. We're trying to take each day as it comes - it's the only option left now.

Thanks again for your lovely comments. Please keep your fingers crossed that I won't be posting again on here for some time... xxx
Posted by: Penny Hudson Posts: 155 - Joined: Tue Mar 13th, 2012 03:35 pm

#943 - by Penny Hudson >> Tue Nov 24th, 2015 04:12 pm

So sorry Cathy you've had your hopes dashed ; the side effects of the chemo sounds awful and as you say his quality of life would be zero. Bless his little heart; hope he continues to be well and happy and that this carries on for a long time. Sending love and hugs and special hugs for little Bertie. Take care and fingers crossed you won't be posting on here again for a long while xxx xxx
Posted by: Shailen Posts: 100 - Joined:

#944 - by Shailen >> Tue Nov 24th, 2015 10:23 pm

Thanks for the updates Cathy and I just want to second Penny's lovely words as well. I hope you have a good amount of time left with Bertie having a good quality of life. We are always here as and when you need us. Hugs to you and Bertie xx
Shailen (The Ralph Site founder)
Posted by: Michelle Ball Posts: 66 - Joined:

#945 - by Michelle Ball >> Wed Nov 25th, 2015 03:27 am

Hi Cathy

I've just read your recent posts...im sorry to hear there isn't an effective treatment for little Bertie. The most important thing of all is that you are enjoying your time with Bert, and he sounds so happy and full of life.

Take each day as it comes and relish the time you have left. I wish you and Bertie all the best.

Hugs for you both
Michelle xxx

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