I have aged five years and lost five pounds in as many days. Forgive how scattered this post may end up; my hands are trembling as I begin to write.
The twelfth of July was a very special day. Dexter had made it home from the hospital, ate a little, and was looking more bright-eyed than I had seen in a week. He slept between us on the bed, where I turned him over every couple hours and massaged his back legs, where edema had turned them into sausages. You could massage the fluid out, but it eventually made its way back. They felt like those gel-filled stress balls. The next morning he spent on the balcony, soaking up the sunlight. He was not interested in food, but I managed to get his medicine in him.
I wanted to take him to some of the places he loved to walk to, but there was no way with his anemia and the weight from his abdominal fluid that he could get there on his own. M had been half-jokingly asking for years for a Radio Flyer red wagon she could use to pull the dogs around town. I thought, “Why not?” Something made me get up and head to the store, where I found the last wagon in the city. As I carted it away, I walked by a clerk at the store talking on the phone: “No, they were out of the Radio Flyer wagons, someone just took the last one.” That was spooky timing.
As the day wore on, something inside told me that maybe I was missing something, maybe we needed a new set of eyes to look at Dexter — I was too close to him, too focused on trying to help him and care for him, and maybe I was missing some key symptom that would explain everything; something that could be treated.
The day before, I received a card from Dexter’s oncologist, noting where her new practice was located: a veterinary specialty center in town. I called and they said bring him on in. I loaded Dexter into his wagon and off we went. I had to carry him into the center: he had so much fluid in his belly (he weighed 62 pounds … 10 more than a week ago), and just couldn’t walk very far, even with help.
Dexter’s regular vets had kindly faxed over his latest records, and spent time on the phone with the oncologist explaining what had been happening. She came into the treatment room, where I explained that I was afraid I might be missing something, and wanted to make sure that I live up to my promise to give him every opportunity. She explained that there were treatments we could do, like plasma or blood transfusions, IV fluids, and the like, and we could hospitalize him and get started tonight, but that there was almost no way that Dexter would survive the treatments. I had already promised him that I wouldn’t leave him in a hospital again, so that, coupled with his likely not living through it, meant that transfusions and more needles and medicines and pokes and prods wasn’t an option. She added that even if he did survive the treatment, he would still have to fight another high grade sarcoma, which is hard enough when you’re healthy.
I don’t normally speak so bluntly, but you have to ask yourself how deep a hole are you going to put him in, and then expect him to climb his way out? This is not the Dexter I saw two months ago. I think this is the end stage Dexter. It’s time to start thinking about euthanasia.
The welling of tears in my eyes burst into streams as she gave me a box of tissues. I apologized.
It’s OK, this is oncology, everybody cries in oncology.
I wasn’t ready for euthanasia, M wasn’t with us anyway, and after all, I just got him the last red wagon in Chicago, and he had barely used it. His oncologist said that she would give him some comfort by draining fluid and I could take him home. He wasn’t in any pain, but the amount of fluid in his abdomen made moving and walking difficult, and he was damned miserable. The treatment was a risk: he could go into shock right then and there, or the fluid that was removed could merely be replaced, leaving him worse off than before, even dead. We went for it. He deserved some relief from the bloating and swelling.
After a couple hours, the door opened and he stormed in, face swollen from the fluids they injected under his skin to hydrate him, but on his own four legs and walking under his own power. The swelling in his back legs was gone, so he could walk instead of waddle for a change. They had managed to drain 3 liters of fluid — between half and two thirds of the total volume. That’s the equivalent of two and a half GALLONS of fluid in a 150 pound human. I wouldn’t have walked around much with that sitting in my belly, either.
For the first time in what seemed like weeks, but was really days, he walked in front, on his own, demanding that I get him the hell out of that hospital and back into the car, immediately. He even tried to jump into the back seat on his own. When we got home, he walked over the threshold and through the front door on his own, headed straight for the couch, and curled up. He shivered, and M covered him with a blanket. Unmistakably pissed off at me, he dozed off and on as he built his strength back up, and I had to have the most difficult conversation I’ve ever had.