As it turns out, Dexter’s health problems don’t stop with the cancer. While otherwise he’s a good candidate for lomustine chemotherapy, his liver enzymes have to be at normal levels before he can start. He has a “hot” liver under ultrasound (OK, hyperechoic), but no masses or nodules can be seen. Unfortunately, though, his enzymes are high, and growing higher, and his red blood cell count is low and dropping. He just got over separate UTI and GI tract infections, and he has developed some gastric motility issues … basically, he wasn’t able to digest food, it just sat in his stomach without moving through the intestines and into the colon. There’s also fluid buildup in the abdomen; it isn’t contiguous, so you can’t do a simple stick-and-drain, which is what we tried yesterday. We can’t do the chemo when he has all this other stuff going on. The main issues are getting him nutrition so he can heal up from the infections and get his red cell count back up, and then get the enzymes down so he can get start the chemo.
Welcome to Good by Dog. We’ll get to what that means later. The important things first. This is Dexter. He’s more than likely a pit bull – boxer mix. I say more than likely because he’s a rescue dog, saved from a shelter in central Illinois, in a town where breed ignorance is so persistent that the vet he visited for his first shots and neutering made sure to list his breed as “Terrier mix” on the rabies form. Without that courtesy, one would be very, very hard pressed to find a place to rent that would accept your application. Ironically, the only reason Dexter made it out of that kennel with M was that he was the only dog that she could walk in their play area — the rest pulled too hard, barked, jumped, whatever … they were just excited, of course, not bad dogs by any means. When M entered the room, Dexter looked up, saw her, and put his head back down, likely thinking what anyone else would think: no way this five-foot-tall-ninety-five-pound-just-graduated-from-college-young-woman would be able to handle him. He’d be too big, strong, and scary … all barrel chest and teeth and muscle. When she got him on the leash, he stood up … never barking, never jumping, never pulling … and walked calmly beside her in the run, happy someone would take the time to give him a chance. Before she left the kennel that day, she went back to him and whispered “Don’t worry, I’ll be back for you tomorrow.” She paid her deposit, filled out the forms, and the next day she bummed a ride from a friend to get her and Dexter back to his new home. That was 14 years ago.
Dexter has cancer. Well, he’s had cancer in the past, actually, and more than once. In 2006 he had (most of) a mass removed from his elbow: spindle cell sarcoma. It grew back three years later, which we expected since they couldn’t get it all out, and we had it, as well as a big fatty tumor underneath the muscle on his left side, removed. This time it was well encapsulated and amazingly the whole thing came out.
A couple months ago, after noticing a weight loss and lethargy that couldn’t be explained by old age (he is 15 years old, after all), we had an ultrasound done and got the bad news: Dexter had mass in his spleen, and it looked like there was something in his liver as well. Splenic tumors in dogs come in a few different types, and none of them have a very favorable prognosis. In general, you’re looking at a matter of weeks … by the time symptoms appear, this very aggressive cancer has already spread to the liver and other organs. Dexter had his spleen removed shortly after the ultrasound.
Dexter got lucky, in a perverse sense of the term. Though the biopsy couldn’t definitively state what type of cancer he had, all signs pointed to histiocytic sarcoma. This is kind of like being picked second to last in gym … it’s not the worst, but it’s pretty awful anyway. In a further burst of defiance, Dexter’s tumor seemed to be completely contained within the spleen, and during surgery there didn’t appear to be anything going on with the liver. With chemo, we could shoot for six more months with Dexter alive and well, and with some luck, a year or even more. Sometimes, and not a lot is known about these cancers, in fact only recently have we even been able to differentiate between the different types that occur, removal of the organ is curative.
That’s when I decided to start Good by Dog. The name comes from a promise I made when he was struggling a bit recovering from surgery … I told him I would do everything I could to make sure that every day he had left would be “good by him.” No more excuses, no selfishness, no I’m too tired for a decent walk, no I’m too busy staring at a computer to spend time with him. I wanted to make sure that every night he and I would be able to look back and be satisfied; that every day from then on out would be “good by Dexter.” Good by Dog came around not only because I figured that there are bound to be plenty of other people struggling with similar issues, but because the world would be a much better place if everyone in it would live their lives Good by Dog. Doesn’t matter what dog, really, or even that it is a dog in the first place, but the important part is that we tend to be better people when we set high standards for ourselves. Good by Dexter is mine, and I hope Good by Dog will be yours.