Respectful Insolence

i-9d863292f8086a50681125ead0b9aeaa-IMGP0024.jpg

Today is Friday, which has normally meant for the last two years that it’s the time every week when I poke fun at some particularly outrageous woo. Indeed. I even had a great idea for a 4th of July-themed post today that (I hope) would have been hilarious. I had even started to write a bit of it a couple of nights ago.

Then real life intervened, and I didn’t feel the least bit like humor last night. I still don’t feel capable of humor this morning, either. Those of you who don’t have pets may want just to skip the rest of this; you may not understand why I’m feeling so down and may view this post as nothing more than self-indulgent whiny twaddle. But what is the purpose of a blog if not to be an outlet for self-indulgent twaddle from time to time? Of course, those of you who do understand (which, I hope, is the vast majority) won’t view it that way.

Yesterday afternoon, eight years to the day after the day we first picked her up from the shelter, my wife and I learned that our dog Echo, the sweetest, most even-tempered dog in the world (unless you’re a bunny), has terminal cancer. There will be no more bunny carnage in our yard.

i-e7010b5c4cc4dbf92b826aaa0dccb9d8-IMGP0012.jpg

It all began last weekend, when we noticed that Echo was favoring her left hind leg. At the time, I also noticed an asymmetry in her hips, with a bulge on the left side. I palpated the area and found what I thought to be a soft tissue mass. A large soft tissue mass. Remember, I’m a surgical oncologist; I’ve palpated many, many soft tissue masses in humans, and this one felt ominous. It was hard, fleshy, and big. I suspected sarcoma right away, as it felt a lot like many sarcomas I had felt in human patients.

Still, I’m not a veterinarian, and I wasn’t entirely sure. In retrospect, I’m sure it was denial, but by the time I took her to the vet for the first time on Tuesday I had convinced myself that it was an orthopedic problem, not a soft tissue mass at all. It just goes to show that denial isn’t just for patients; doctors can fall prey to it as well. In any case, I had taken her for a walk on Sunday and noted her favoring the leg, but otherwise she seemed more or less normal, although my wife and I had also commented at times recently that she seemed to become easily winded compared to her old self. However, we had just attributed this to her getting older and the fact that we had been remiss in getting her enough exercise lately; so our initial thoughts were that we needed to take her out on walks every day and try to get her (and us) into better shape.

The visit to the vet on Tuesday confirmed that it was definitely a mass, and I got that ominous sinking feeling when the vet was kind of vague about what he thought the problem was. It’s not just people doctors who do that. Still, I remained optimistic. We just so happen to be lucky enough to live a mere two or three miles from one of the best veterinary oncology hospitals in the region, and I made an appointment for yesterday afternoon. Showing the power of denial again, by yesterday morning I had convinced myself that this mass would be resectable and that at the worst it would require an amputation of that limb. I was even joking that I guess I wouldn’t be buying that new car that I was contemplating buying if I ended up spending $10,000 or $20,000 on surgery and radiation for the dog. (Many of you who love your dog or cat as much as I love mine know you’d spend that much and more too, assuming you have the money, if there was a decent chance it would save her life.) Heck, I even managed to hold out hope that it was an inflammatory or infectious mass rather than a tumor, given that the fine needle aspiration (FNA) of the mass showed nothing more than blood and white blood cells.

A fantasy, I now know, but a useful one.

Yesterday afternoon, I blew off work early and accompanied my wife to the veterinary surgical oncologist. Yes, there is such a specialty. Just as I’m a surgical oncologist for humans, this surgeon was a surgical oncologist for animals. Better yet, this surgeon had been in practice for some 25 years and is well-respected nationally. He treated Echo with the utmost care as he did some X-rays, an ultrasound, and another fine needle aspiration of the mass. (In retrospect, maybe I shouldn’t have allowed the general vet to do the FNA; as is the case with humans, surgeons tend to be much better at doing them. But I wanted an answer, and I didn’t want to wait a couple of days for it. I ended up waiting anyway.)

The news was, as I said, not good.

The primary mass looked classically like a hemangiosarcoma with bleeding into the center of the tumor, which is probably the reason for its rapid transition from not noticeable to a large mass. There were multiple masses in her liver, and her spleen was enormous, chock full of hemangiosarcoma. She even had some enlargement of the right atrium of her heart, suggestive that tumor was there, too, as is common for this cancer. There was the explanation for her increasing shortness of breath. There was nothing that could be done. Game over.

Hemangiosarcoma is an incredibly nasty and insidious tumor in dogs. Indeed, one of the more common ways that it makes itself known is when a dog just drops dead for no apparent reason, and an autopsy shows the cause of death to be massive bleeding from one of these tumors. Usually, by the time the tumor becomes apparent clinically, it’s far advanced, and this was the case with our poor Echo. Upon the diagnosis, my wife and I both felt tremendous guilt that we hadn’t noticed this before. Indeed, now that I know her diagnosis I look at her and I can see the bulge in her abdomen from her enlarged spleen. Why hadn’t I noticed that before? What kind of surgeon am I? However, after reading just how nasty this tumor is in dogs and how it’s rarely noticed until very late, we feel less so. Sadly, Echo is a classic case, a dog between the ages of 8 and 10, whose tumor didn’t cause signs and symptoms until it was far too late to do anything about it.

There’s also a horrible irony here that is eating at me. It’s more than just my profession as a cancer surgeon. After all, cancer is a common disease and common cause of death in both humans and animals. Few people make it through life untouched by its deadly hand, either in family members or personally–or even in pets. Rather, it’s the kind of tumor. Hemangiosarcomas arise from vascular endothelial cells, the cells that line the inside of blood vessels and capillaries. What’s one of my areas of research interest? Tumor angiogenesis. What cell is critical to tumor angiogenesis? Vascular endothelial cells. I study vascular endothelial cells as one of my two primary areas of research interest. Lovely.

What’s hardest to deal with now is how normal Echo behaves at the moment. True, last night, in the shock of the diagnosis, my wife and I thought she looked so very, very ill given that she was sleeping a lot and seemed to be breathing heavily, but this morning she seemed back to normal, even spunky. We’d never know there was anything wrong with her were it not for the small shaved spot on her hindquarter where the FNA had been done and the bulge lying right underneath it. She did her usual morning routine of planting herself near the front door and waiting for people to walk by with their dogs, at which point she’d start barking. She loves protecting the house this way and driving away interlopers. Normally, this behavior drives me absolutely loony, but this morning I treasured it, because I know it won’t last very long. Soon, something bad will happen. Either the tumor on her spleen will bleed and she’ll collapse into unconsciousness (in which case she will probably die quickly), the tumor in her heart or anemia will make her increasingly short of breath, or she’ll stop eating and drinking. When one of those things happens, my wife and I will know it’s time to act expeditiously to end her suffering. In the meantime, we’ll give her lots of love, lots of treats, and, while she can still physically handle them, lots of walks. Eight years, it’s too short. We had hoped Echo would live at least another few years, or even a couple more.

I hate cancer more than ever right now.

To complete my self-indulgence, here are some pictures.

Here she is just this morning:

i-d81f10a637f826613eff6c4694c34889-Echo1.jpg

Here she was in her youth, charging through snow banks (she’s very difficult to photograph, especially in the snow, because she’s so black):

i-391c8c4304cf81842096d783711d9b2b-Echo5.jpg
i-ed06c6c9ba9821cefcd09db4ad756a86-Echo7.jpg

And, best of all, just chillin’ a few years ago:

i-b5a4d4ed6044dff2034bf81967352fb6-Echo6.jpg

Comments

  1. #1 Liesl
    July 4, 2008

    Oh, Orac, I am so, so sorry.

  2. #2 ca_geologist
    July 4, 2008

    I’m so sorry.

  3. #3 Lilly de Lure
    July 4, 2008

    I am so sorry to hear about Echo Orac – you must be devastated.

    Much sympathy to you and your wife, and to Echo.

  4. #4 Neal MacDonald
    July 4, 2008

    You have my condolences. I lost my canine best friend to cancer a few years ago, it was terribly sad.
    Take care.

  5. #5 Mac
    July 4, 2008

    I’m so sorry, Orac.

  6. #6 Mike
    July 4, 2008

    I do know what you’re going through, and I’m really sorry anyone has to go through it. Really sorry.

  7. #7 Kelly
    July 4, 2008

    I’m so very sorry. A disease that is so unfair…

  8. #8 Katharine
    July 4, 2008

    Sorry to hear about your dog’s cancer. I just euthanized my dog three days ago and feel like a massive load of shit. He may have had cancer himself.

    From one grieving former pet owner to a pet owner who will be grieving soon, love the hell out of your dog and don’t prolong her suffering any more than you need to. And believe me when I say that even if you know she’s going to die, nothing will prepare you for her death, and you will probably feel a dog-shaped void in your life for quite a long time.

  9. #9 Jyotsana
    July 4, 2008

    *hug*

  10. #10 Beowulff
    July 4, 2008

    Sorry to hear this. Don’t bother about the Friday Dose of Woo, use all the time with her that you can get. I wish you and your family strength for the days to come.

  11. #11 Tricster
    July 4, 2008

    I know how this feels, and I’m so sorry. I lost a beloved pet to cancer many years ago; probably the same sort. I heartily agree that you spend as much time as you can with her, playing and spoiling her.

    It always seems that they go before they should.

  12. #12 Bob O'H
    July 4, 2008

    My condolences too, Orac. At times the Fates have a cruel sense of humour.

    As Katherine said, love the hell out Echo whilst you’re still able to. And give her a big hug from all of us online.

  13. #13 Patrick
    July 4, 2008

    Wow, I’m really sorry to hear that. Lots of poochy love from mine to Echo.

  14. #14 anjou
    July 4, 2008

    Saddened to read this news.

    Lost my 8 yr old dog to lyme nephritis last year. She spent 2 weeks at the vet hospital on hydration ect, but nothing would turn it around. It was awful.

    Enjoy the time that’s left.

    Cancer truly sucks.

  15. #15 Jo
    July 4, 2008

    Orac, my sympathies. I lost a Greyhound to hemangiosarcoma several years ago. The only reassurance I can offer is that Bucky did great until he quite suddenly stopped doing so. You and your wife and Echo will be in my thoughts.

  16. #16 Left_Wing_Fox
    July 4, 2008

    My deepest condolences Orac. I hope your time with Echo will be as full of joy and as free of pain as possible in the coming days. Live, Love, and keep fighting the good fight.

  17. #17 Niobe
    July 4, 2008

    I bet you’re having a blast of a 4th of July.
    Even if the post is “self indulgent”, there is lots to learn in here.

  18. #18 the skeptical sorcerer
    July 4, 2008

    so sorry to hear about your dog Echo, Orac. I really wouldn’t feel bad about not noticing things sooner, I think looking back on the past makes the way events actually turn out look really obvious even if they were not(I hope that makes sense, I think I may have worded things weirdly).
    Much love and condolences *virtual hug* <3 <3

  19. #19 Danio
    July 4, 2008

    You and your family have my deepest sympathies, Orac. I really appreciate your sharing this story with your readers, and wish you as many pleasant days ahead as possible with your beloved Echo.

  20. #20 NickG
    July 4, 2008

    I’m so sorry for you all.

    Though the good thing is Echo has good owners who will give her lost of treats, lots of love, and a painless end. She doesn’t know what you and your patients do. She has no fear of death. She just knows the treats are hella awesome and way more frequent now. Why did they have to wait eight years to give me an entire cheeseburger of my own? But hey, maybe you *can* teach an old human new tricks… this is freaking great!

  21. #21 Kassiane
    July 4, 2008

    I’m so sorry. Echo is beautiful. It’s not fair.

  22. #22 borealys
    July 4, 2008

    Oh, Orac. She’s beautiful. I’m so, so sorry.

  23. #23 Matthew L.
    July 4, 2008

    I’m sorry. Losing a dog always sucks. May Echo have as many good days with you as she can.

  24. #24 Celeritas
    July 4, 2008

    I’m sorry. My dog died of the same thing and died on the table as it was being diagnosed. Echo sounds like she has a great family to be with though, Orac, I’m sure she’ll be happy.

  25. #25 rlbates
    July 4, 2008

    So very sorry about Echo. I lost my sweet Girlfriend to this same cancer Sept 2007. I lost two other dogs to other cancers. So very sad, but try to recall all the joy they brought you and you them.

  26. #26 David Ratnasabapathy
    July 4, 2008

    Sad… so sorry to read this. May she die happy, knowing she is loved.

  27. #27 HCN
    July 4, 2008

    Oh, I am so sorry. It just takes a chunk out of your heart whenever a dear pet passes. Even though the first cat I got as an adult lived very well for 19 years, it was very sad when he died.

  28. #28 Dr. Kate
    July 4, 2008

    True, deepest sympathies.

    Okay, I have to go now, I’m crying on my keyboard.

  29. #29 Ms. Clark
    July 4, 2008

    In my house we joke that our dog says she isn’t an animal but a “person of fur.” I feel sad for how you are feeling about the loss of Echo’s health. I hope she is able to stay happy and relatively healthy for as long as possible.

  30. #30 Barn Owl
    July 4, 2008

    So sorry to read this, Orac-I know how heartbreaking it is. With a shelter/rescue dog or cat, you have at least some small comfort knowing that you gave the animal more time, and better-quality time, than it would have had without your intervention and love.

    *hugs*

  31. #31 ehoffman
    July 4, 2008

    She’s a beautiful dog. I’m so sorry for all of you…

  32. #32 Sheri
    July 4, 2008

    My heart goes out to you, Orac. It was 10 years ago this week that my husband and I said goodbye to Quasi, the most amazing dog we’ve ever had the privilege to live with. His cancer was also quite advanced when we first noticed he was having problems. May Echo’s passing be swift and peaceful, in the arms of the humans who love her.

  33. #33 Janice
    July 4, 2008

    I’m so very, very sorry. Saying good bye to someone you love is never easy. I hope you & your wife can take some comfort in knowing that Echo realizes that she is loved & cared for. Lots of treats, pets & hugs to you all.

  34. #34 Alison
    July 4, 2008

    It’s so sad to lose a pet, no matter how many times you’ve gone through it. Don’t blame yourself for not seeing it – our pets rarely give us any indication that they’re ill until they simply can’t hide it. 8 years seems like so little time to us, but our pets live in the moment – all Echo knows is that she’s been happy her whole life, and it’s because of you and your wife.

  35. #35 NurseExec
    July 4, 2008

    I lost my beloved Alaskan Malamute, Atu, to adenocarcinoma. My sympathies are with you and your family–our pets complete our lives, don’t they? You are all in my thoughts.

  36. #36 kristina
    July 4, 2008

    much sympathy—she’s clearly loved!

    my son has a particular curiosity about black dogs (tinged with wariness; he’s just getting over years of complete fear of four-footed friends) and he’d have an eye on Echo.

  37. #37 AJohns
    July 4, 2008

    Orac, i’m sad beyond words. My wife & I have been married 38 years, we have had 3 dogs, Junior, Missy, and Harley. Had to put the first two down for similar problems after having them for 15 and 14 years. I’m a surgeon also (gynecologist), but putting those 2 friends down was, by far, the hardest thing i have ever done. In a lot of respects, dogs are far better friends than humans.

  38. #38 Liz Ditz
    July 4, 2008

    I was sorry to read this. You, your wife, and Echo will be in my thoughts.

  39. #39 AnnR
    July 4, 2008

    I’m sorry.
    I hope she can still sit out in the yard and bark at the bunnies.

  40. #40 thordora
    July 4, 2008

    I’m so sorry. I’ve had to put two cats down over the last 5 years, and it’s so heartbreaking. It sounds like she’s had a fabulous life though-try and find some comfort in that.

    My sympathies are with you.

  41. #41 AnnR
    July 4, 2008

    I’m sorry.
    I hope she can still sit out in the yard and bark at the bunnies.

    I lost a special human friend to cancer yesterday.
    Human or canine – it sucks

  42. #42 marcia
    July 4, 2008

    I’m very sorry about your pet’s diagnosis. We’ve euthanized 11 pets in the past 11 years.

    They say, “oh you must be used to it.”

    I respond, “no.”

  43. #43 CanadaGoose
    July 4, 2008

    I’m so sorry. It’s terrible that these wonderful creatures live so short a time. I knew I’d cry reading about Echo because she’s the dog we all have had that we love best.

  44. #44 Bronze Dog
    July 4, 2008

    It’s always hard to deal with the mortality of beloved pets.

  45. #45 Cassidy
    July 4, 2008

    My condolences, Orac. I got my first pup the day I moved out of the dorms in college, and she’s with me every minute I’m not at work or in class. I can’t imagine what I’d do if something happened to her. I hope the time she has left is filled with bunnies!

  46. #46 DonZilla
    July 4, 2008

    Dear Orac,

    One of the best things you can do is thank Echo for all the wonderful years she spent with you. I’m also spending this weekend with my 14-year-old Sheltie whose kidneys may have been blown out by an overdose of BP meds his vet prescribed. He still has his moments of joy and normalcy too, but most of his life now is sleep and nausea. So I thank him for those joyful moments, thank him for what little he can still eat and drink, and thank him for spending so much time with me.

    Don’t feel bad for not noticing her symptoms earlier. In the wild, if animals showed symptoms, they’d be targets for predators; I believe hiding illness and injury is an inherent trait. I’ve had more time to come to terms with my dog’s death than you have (his kidneys started failing back in November) and it hurts just as much no matter what.

    To Echo: Thank you, thank you, thank you, beautiful girl.

  47. #47 Art
    July 4, 2008

    You have my sympathies.

    But, in the end, all of us have to live the best we can and then move on. Echo will have one of the better deaths. To go along with one of the better lives.

    What more could any sentient being ask for than to spend your life accepted, loved, cared for and to return the favor in kind. To enjoy that joyous state of existence until the final breath knowing you have had a full and good life.

    Mourn your own impending loss. It is your right and duty. But don’t mourn Echo. Echo has had and returned the best that life has to offer. That is as good as it gets. It is a cause for celebration not mourning.

  48. #48 Shay
    July 4, 2008

    We lost one of our dogs to a tumor on his spleen a few years ago. There is no easy way to make the decision you are facing. I am so sorry.

  49. #49 The Ridger
    July 4, 2008

    I’m so sorry. As others have said, don’t ever beat yourself up for not noticing. Love her hard while she’s still with you.

  50. #50 DVMKurmes
    July 4, 2008

    Sorry to hear the bad news, hemangiosarcoma sucks. My dogs and I hope she gets another rabbit. If my dogs could they would be happy to help her catch one.

  51. #51 chris
    July 4, 2008

    Sorry to hear this. She’s a beautiful dog.

  52. #52 Regan
    July 4, 2008

    Such sad news.
    Echo is very beautiful, and an obviously well loved member of your family.
    I hope you all have many more happy moments in the time left. Yes, treats, lots of treats, walks and play.

  53. #53 Kaye Reeves
    July 4, 2008

    What a sweet and noble animal is Echo. Your blog, despite the sorrow of today’s entry, makes me wish I could have a dog-companion (but our four cats hate each other, much less a canine interloper). You and your family and Echo will be in my thoughts.

  54. #54 Bluegrass Geek
    July 4, 2008

    I’m sorry to hear this, Orac. I lost a pet and best friend a few years ago. He lived with congestive heart failure for several years, until he began to have seizures one day. The doctors prescribed some new medicine, but after another one, we couldn’t bear to have him suffer the way he was.

    The hardest damn thing I’ve ever done in my life was to hold him while the vet gave him the shot that ended his life. I still feel horribly guilty over it, even though I know he would’ve just been in pain until he finally did give up. I miss him terribly.

  55. #55 "GrrlScientist"
    July 4, 2008

    my heart goes out to you, orac, but i lack the words .. .. so i will let someone else capture my thoughts for you;

    Don’t stand by my grave and weep,
    For I am not there.
    I do not sleep.
    I am a thousand winds that blow,
    I am the diamond’s glint in the snow,
    I am the sunlight on ripened grain,
    I am the gentle autumn’s rain.
    In the soft blush of the morning light
    I am the swift bird in flight.
    Don’t stand by my grave and cry,
    I am not there,
    I did not die.

    ~ Unknown Native American Author

  56. #56 Susannah
    July 4, 2008

    So sorry.

    I lost my long-time companion and friend (feline) over 10 years ago. I still miss him.

    You will be in my thoughts.

    And keep us informed of her condition, please.

  57. #57 Eric
    July 4, 2008

    “All the love you passed our way
    The angels have waited for so long, now they have their way
    Take your place”

    “Life Without You” – Stevie Ray Vaughan

  58. #58 SC
    July 4, 2008

    Terrible news. I know how hard this is, and my thoughts are with you.

  59. #59 Joshua Zelinsky
    July 4, 2008

    My condolences. My family had a dog that died of cancer. She was already old and arthritic when she got stomach cancer. She slowly ate less and less and then we finally had to put her to sleep. I’ve lost both family members and pets to this disease and it sucks. I’m very grateful for all the research being done to stop it.

  60. #60 Julie Stahlhut
    July 4, 2008

    I’m really sorry to hear about Echo’s illness, Orac. I know you’ll do whatever is best for her. My thoughts are with you.

  61. #61 Janice in GA
    July 4, 2008

    My heart goes out to you. We lost our best-beloved Sasha to hemangiosarcoma in 2003. Our case was similar to yours, in that we knew she’d been slowing down, but she was getting older (almost 9), and we attributed it to that. We had no idea how seriously ill she was. Except for getting tired, easily, she was pretty normal up until the day when she collapsed and died in the vet’s office. I had a necropsy done because I wanted to know what killed her.

    She had hemangiosarcoma in her heart and lungs. She’d had a bleed and died quickly. But we didn’t guess it was coming, and her death almost killed us too. :(

  62. #62 Brian X
    July 4, 2008

    Sorry to hear it, Orac. Our dog is a schnauzer, and they’re notoriously cancer-prone. The groomer thinks she might have a seizure problem, and I’m worried she won’t be around too much longer since evidently that’s a symptom of brain tumor. She is easily the nicest and most chill dog I’ve ever known.

  63. #63 CanadianChick
    July 4, 2008

    (((((hugs)))))

    I’m so sorry to hear about your poor Echo…spend lots of quality time with her while you can…

  64. #64 thalarctos
    July 4, 2008

    Orac, I’m very sorry to hear the news. It’s totally unfair. I wish you, Mrs. Orac, and Echo all the possible quality time.

  65. #65 A Regular Lurker
    July 4, 2008

    I’m so sorry for Echo’s illness. Know that she loved you and loved life because of you.

  66. #66 OmegaMom
    July 4, 2008

    I’m sorry, Orac. She’s a beautiful dog.

  67. #67 Deb
    July 4, 2008

    Dear Orac:

    I know exactly what you are dealing with. My beautiful girl, Bonnie, has also been diagnosed with hemangiosarcoma. I saw a big lump on her right hip – we had a punch biopsy done (and talk about bloody). Pathology revealed hemangio. The mass is too large to remove – no tissue to do any ressectioning. In our case – it doesn’t appear that it has spread to any other organs…yet. So far, she is doing great – eating and being a regular dog, although she is crooked with that massive lump. She is a 10 year old Bernese Mountain Dog. I am well versed with cancer with this breed (having lost several to malignant histiocytosis). At least with hemangio – they do not get so sick that they stop eating and waste away. My vet tells me that she will bleed out and it will be painless.

    I feel your pain and I know what you’re going through. Hold her tight – love her, kiss her, pet her. Tell her she’s a good girl and just enjoy the remaining days.

    When I loose one of my precious fur kids (I won’t let them suffer – I will always euthanize when they are in great pain – although in the case of hemangio, it will be different), I hold them to the end. I clip their hair (they have three colours) to keep and I put that hair pressed behind the glass of the picture frame that will hold their “forever” picture. I also cremate all my fur kids and put their urn next to their picture.

    My friend you are not alone. If I can be of any help please email me. I’ve been down this road many times.

    Hugs,
    Deb

  68. #68 Samantha Vimes
    July 4, 2008

    ::pets doggy::

    So sorry to hear it.

  69. #69 BlackOrchid
    July 4, 2008

    Orac, I am so, so sorry!

    We lost our beloved dog Loki last fall to hemangiosarcoma. Still devastated. We had about a year after initial diagnosis (after a ruptured spleen nearly killed him). Here is our goodbye post in case you’re curious:

    http://www.houseofthedog.com/2007/10/in-memoriam.html

    I’m heartbroken for you and your family, and for everyone else here in the comments who has gone through this. it just brings it all back.

  70. #70 deb
    July 4, 2008

    Oh – and Orac – this lump appeared out of no where. It grew at a fantastic rate. I was like you….where the hell did this thing come from? Why didn’t I see it before?

    It is like a mushroom – overnight it was just there.

    I hate cancer too,
    Deb

  71. #71 Alan Kellogg
    July 4, 2008

    And she can’t understand what’s wrong. It’s something beyond her comprehension. All she can know is that something is upsetting her people, and that they need some comforting. So it’s more cuddle time, more time sitting with her humans; they comforting her, and not really aware it is her who is comforting them.

    Orac, know when it’s time to let go. She may die in her sleep, or during a walk or a cuddle, but be prepared to make that last act of kindness. And know there is a man in California who sympathizes with what you and the missus are going through.

  72. #72 medrecgal
    July 4, 2008

    Orac,

    Truly sorry to hear about your lovely dog…I lost a much loved cat to a nasty cancer a few years back, so I know how hard this must be. I’m sure you’ve heard this and thought this often as a surgical oncologist, and it’s a simple truth whether we’re animal or human: cancer sucks. Here’s to hoping Echo beats the odds.

  73. #73 Craig Willoughby
    July 4, 2008

    Orac, you have my sincere condolences. She is a beautiful dog, and I know exactly what you are going through. Just this past month, we lost our dog to old age, and my family (my autistic son in particular, whom he was best friends with) is still very much distraught. These animals come into our lives, and whether we want them to or not, we begin to think of them as family, and in many cases, as our furry children. I hope things go well, and if she does pass, I hope it is without pain and in the company of her loved ones. Good luck to you and your wife.

  74. #74 varkam
    July 4, 2008

    Orac,

    I know how you can get quite attached to pets. They pretty much become part of the family, and so I can empathize with you in your situation. I know sorry is cheap, but it’s all that I’ve got.

    Cheers,
    varkam

  75. #75 Elaine
    July 5, 2008

    I’m so sorry. I lost my cat to cancer years ago and it was so difficult. I hope she can stay happy and active for as long as possible.

  76. #76 wanderingprimate
    July 5, 2008

    Strangely, these times can be as precious as the early years.

    Walking this path with our clients & patients -really friends and beloved companions- is a special & unique experience…a gift & honor to ease discomfort as best we can and be witness to incredible & intimate depths of emotion and bonding.

    It’s apparent that the gift of love & life worth living has gone both ways. Thanks for giving Echo a great one.

  77. #77 Harrison
    July 5, 2008

    Thank you for sharing this story. Echo knows she’s loved (OK, when it comes to pets, I’m super anthropomorphic) and I’m sure you enrich her life as much as she enriches yours. Please give Echo a hug for me.

    Take care.

  78. #78 Charlie B.
    July 5, 2008

    It’s horrible losing a friend this way. When I was 11, my Labrador William died from cancer, aged only 5. He’d had a lump on his ribs, which was removed, but it was discovered too late. My dad was distraught and tried everything from visits to the best vets he could find to a visit to a faith healer (that a down-to-earth and highly intelligent man as my dad was that desperate to even try a faith healer shows how much the dog meant to him too). Very very sad, he was a lovely guy that Lab.

    So yes, I get it. I’m very sorry.

  79. #79 bastion
    July 5, 2008

    Orac, I’m so sorry to read about your beloved Echo.

    I’ve lost five dogs over many years, and no matter what the cause of their death, I mourned their passing just the same, and I miss them all still.

    I know how sad you feel, and wish you, and Echo, peace. May you hold the joyous times you spent together in your heart always.

  80. #80 alison
    July 5, 2008

    I am so, so sorry at reading this. My own beloved dog is nearing the end of her life, but I can still only imagine what you & your wife must be feeling. Hugs.

  81. #81 Militant Agnostic
    July 5, 2008

    Orac, I am sorry to read about Echo

    We lost a Lab/Rotweiller cross to a post operative infection after a stomach torsion 4 years ago. We had Tesla since she was a puppy and it hit us very hard. But, when we took the nearly full bag of dog food we didn’t need anymore to the shelter we found a big Rotti/Shepherd/Malamute cross that was wearing out his welcome there. One dog’s death may have saved another dog’s life.

    People who say it’s just a dog just don’t understand. Remember the joy she brought you and the new life that you gave her.

  82. #82 DavidCT
    July 5, 2008

    Those of us who love our animal companions know how you feel.
    Others have expressed that better than I can. I just want to add some more practical thoughts.

    If Echo dies quietly without suffering that would be best for you and her. If she just gets worse and becomes uncomfortable then you have to decide the “When” of her passing. This is where the normal cycles of good days and bad of a terminal disease comes into play with our feelings. There is good chance that whatever you decide you will have feelings that it was too soon or too late. Just know that when choosing to end another’s suffering there is no best time.

    Also if you have not had an animal “put to sleep” before, find out from your Vet about the technique he or she uses. When I had to have my cat of 21 years put down, it was not what I had expected. It is best to know ahead of time.

    Best wishes.

  83. #83 Voice 0'Reason
    July 5, 2008

    I’m so sorry about Echo. We’ve lost three cats to cancer this year, so I have some idea of what you’re going through.

    If there were any justice in the world, pets would live much longer.

  84. #84 John Pieret
    July 5, 2008

    As a pet owner and one who understands, my deepest condolences. I think the reason a pet’s illness and death can be so hard on us is that pets are like children, dependent on us for protection and care. It’s harder to accept the inevitable consequences of life when you’ve spent so much time and emotional currency in trying to stave those consequences off.

  85. #85 mark's tails
    July 5, 2008

    Orac, you have my deepest condolences.

  86. #86 Tsu Dho Nimh
    July 5, 2008

    Oeac … hugs are offered. Do what you know she needs you to do – it’s the last kind thing you can do for a pet after all the good times.

    We lost our Akita last year to the same cause, but with far less time to get used to the idea.

  87. #87 khan
    July 5, 2008

    A while back, I had to put down 5 cats in 5 years (complications from old age). The other poster was correct: you don’t get used to it.

  88. #88 J. J. Ramsey
    July 5, 2008

    From what you said about Echo, she looks like a pretty neat dog. I’m sorry she’ll be gone soon.

  89. #89 Orac
    July 5, 2008

    People who say it’s just a dog just don’t understand.

    Anyone who says “it’s just a dog” to me in person is likely to risk physical harm. At the very least, anyone who says that will be subjected to a verbal tirade.

  90. #90 Orac
    July 5, 2008

    Thanks to everyone for your kind comments (even one who really detests me was in this instance kind). I don’t know if I’ll feel much like blogging for a while; on the other hand, blogging is therapeutic. Also, Echo has often been my blog buddy, lying nearby or next to me on the couch while I sat with my laptop in front of the TV set.

    The truly hard thing is that, other than the bulge in her hip and the fact that Echo gets winded fairly easily, there’s little in the way of signs that anything is wrong. Yesterday was a good day in that we had family over, and we took Echo for a decent length walk, during which she did quite well, only getting winded near the end as we approached home. She still sits by the front door, waiting for joggers or people walking their dogs, and barks at them. She still chomps her food and treats. As long as that’s the case, we plan on enjoying what little time we have left with her. My wife (who’s a nurse) starts working nights again this week, and I still work the usual days; so Echo will never be alone for more than a couple of hours at a time.

    In a way, I hope she just bleeds out from her spleen suddenly in her sleep (a common end point of this particular tumor) or something like that, something quick and relatively painless. We’re planning for the case where that doesn’t happen and her condition deteriorates (which will be soon). When that happens we will have no choice but to do the right thing to end her suffering.

    But not just yet. We still have a little time.

  91. #91 D. C. Sessions
    July 5, 2008

    But not just yet.

    One of the hardest things I ever did was look at my twin 14-year-olds and tell them “we’re not doing him any favors” regarding their “littermate” after he fell down as we were heading out for a walk.

    It hurts, Orac — I sure hope knowing that we understand and care helps.

  92. #92 Nan McIntyre
    July 5, 2008

    Do we humans ever get the better of guilt, anticipation, regret etc.?
    There’s never enough time left once you know someone’s dying on you, but even a little is better than a sudden death, I think.

    What a completely beautiful bitch your Echo is!
    She deserves a chorus or two of Ochi Chernye, sung in your best Ivan Rebroff bass.

    Your run-down on this particular kind of tumour is, as usual, a welcome addition to my understanding of cancer in general. Please continue to write, even if it’s not what you think is your usual high quality – it is one of the few science blogs that I always read.

    Btw, is the blanket-sucking a common thing amongst children in your family, doctor? :-) Cutest thing.

  93. #93 Annie
    July 5, 2008

    Echo has been so fortunate to have you and your wife as her stewards and best friends.

    I used to have an animal sanctuary for senior and special needs (read health problems and funny looking disabilities) farm and companion animals. A big part of that was providing hospice care and sometimes euthanizing animals when death wasn’t going to come without unending suffering. There is always that moment of surrealness when their loss doesn’t strike home, but it’s the remembering that will eventually bring comfort.

    Many times they had been abandoned at shelters or were going to slaughter when families traded in for a newer model. Much too often, they were at the very end of life and the shelters didn’t want them to die alone there. So their chronologicial time with me was short. But always, their kairos with me was incredibly and immeasurably rich.

    As you can, enjoy her in kairos instead of measuring in chronos. It’s the depth and breadth and height of her quality of life with you that has in it all of the meaning and preciousness.

    There will never be enough chronos, but the kairos will be enough.

    Best-

  94. #94 Sean
    July 5, 2008

    Strongest sympathy to you and your family.
    I wish I had something clever and wise to say, but I’m a young fool.
    .Sean

  95. #95 Orac
    July 5, 2008

    Update here. So far, so good–for now.

  96. #96 S. Rivlin
    July 5, 2008

    Dear Orac,

    So sorry to hear of Echo’s cancer. My heart is going out to you and your wife in these difficult times. Echo is one lucky dog to have you both in her life for the love and care you are giving her.

    All the best for the three of you,

    Solomon

  97. #97 JakeR
    July 5, 2008

    My wonderful wolf-cross mongrel had to be put down last October due to kidney failure, and it still hurts. Here’s a thought that has given me some comfort:

    “The misery of keeping a dog is his dying so soon. But, to be sure, if he lived for fifty years and then died, what would become of me?”
    –Sir Walter Scott

  98. #98 Sarabeth
    July 5, 2008

    Our first dog as a couple was one of those that chased squirrels in the morning and dropped dead just after lunch from the same tumor. I understand your sadness.

  99. #99 grasshopper
    July 5, 2008

    Sorry to hear that, Orac.
    Our own dog died was euthanized on Wednesday. The dog’s decline was rapid. The previous night he was in fine fettle, the next morning obviously ill and in pain.
    Our vet diagnosed liver cancer after some tests and said he was also bleeding internally. Sounds like it could have been hemangiosarcoma too.
    Anyways, little Noddy is buried in our back yard. He was nearly 17 years old.
    He was a delightful dog. Jaunty. Intelligent as all heck.
    And he had a soul.

    ‘Everybody got this broken feeling
    Like their father or their dog just died.’

    This Leonard Cohen lyric is fitting.
    Dad died 3 weeks ago, too.

    It’s time to weep again …

  100. #100 Chad Orzel
    July 5, 2008

    My parents recently lost their dog to something that sounds like the same problem– he went off his food for a while, and when they took him to the vet, he was riddled with tumors. The poor lunkhead was only five, too.

    My deepest sympathies.

  101. #101 Joseph
    July 5, 2008

    I’m sorry to hear about Echo. I know what that’s like.

  102. #102 GDwarf
    July 5, 2008

    There is nothing I can say that won’t sound hollow and rather meaningless. I lack finesse enough with text to truly get across the emotion I am feeling right now, but I will try my best.

    Reading your post I could only think of my own dog, and how I would react upon hearing this news about him. Whoever it was that pointed out how wrong “It’s just a dog” is right in ways I didn’t think were possible until I got a pet of my own.

    No pet is “just a dog” or “just a cat” or “just a rabbit”, they are family members, and losing one is a terrible thing.

    You’ve always had my respect from your posts in this blog, but now you have my condolences. Please, give your dog an extra pat from me.

  103. #103 mdiehl
    July 5, 2008

    I’m sorry to hear about the furry family member. Losing them is hard. Keep those happy memories handy for tough moments.

  104. #104 Marcus Ranum
    July 5, 2008

    It’s no consolation, but I always try to convince myself that it’s just an honor to have gotten to know a good dog even for a couple years.

    It doesn’t work. Deepest sympathy from me and my dogs Miles and Jake.

  105. #105 Bee
    July 5, 2008

    Sorry, Orac. We lost our beautiful, kind, happy big brown mutt to lymphosarcoma two years ago, and I’m not really over it yet. I don’t think it’s anthropomorphising to say that there’s a person of some kind looking at you out of a dog’s eyes. And it’s good you have a little more time to reassure her that she’s a well-loved family member.

  106. #106 ozzy
    July 5, 2008

    Orac:

    I am so sorry to hear about your beloved Echo. We’ve had our dog for 6 years now and she is definitely a cherished member of our family. I will definitely give my dog a nice bone this weekend and a few extra tosses of the tennis ball. I have to slap myself for all those times I bitch about walking her when it’s freezing out or pouring rain outside. I was not a “dog person” when we got her but I have come to realize that having a dog companion is truly priceless. Enjoy whatever time you have left with Echo to the fullest.

  107. #107 Esther
    July 6, 2008

    I’m so sorry, Orac.

  108. #108 DLC
    July 6, 2008

    sorry to come in late, but it’s been a busy couple of days for me.
    Orac, I hope your friend Echo passes quietly and without pain.
    As someone who has managed to outlive several such friends, I can say I know how you feel. I held on to one dog, a black Labrador-rottweiler mix, as she died from heart failure.
    It sucks.

  109. #109 Steve Wolk
    July 6, 2008

    A man much wiser than I once wrote,”It is through our pets that we learn of the depth and breadth of love without boundaries”. I know all to well the pain you and your family are feeling.

  110. #110 Em
    July 6, 2008

    I just caught up with my blogs this morning. I am so sorry to hear this news. At least you will be there with her.

  111. #111 Squiddhartha
    July 6, 2008

    Allow me to add my sincere condolences. This sounds very similar to the sudden decline and passing of our red Doberman, Samson — over the course of two or three days he started gasping and wheezing, and when I took him into the vet, they saw something “riddling” his chest X-ray. They couldn’t do anything for him, and he died on his own before I could even pick him back up to take him to the CSU vet school.

    He was about 6 years old when we got him, and we only had him for a couple of years, but he was an enormous dog and had an enormous impact on our lives. We’re grateful for the time we had with him (and we’re grateful that our other dog is still with us after 14 years, though she’s showing her age).

  112. #112 Tracy W
    July 6, 2008

    I am so sorry to hear this. It was hard when our family dog died. You know what they say about dogs? “If your dog thinks you’re wonderful, why ask for a second opinion?”

  113. #113 Fragano Ledgister
    July 6, 2008

    Orac, just saw this. You have my condolences.

  114. #114 M
    July 6, 2008

    My condolences.

  115. #115 Robin Levett
    July 6, 2008

    I know that “me too” posts are frowned on on blogs as well as Usenet – but “what they said”.

  116. #116 Duke York
    July 6, 2008

    I so sorry to hear about his, Orac. My condolences.

    Duke

  117. #117 Greg
    July 6, 2008

    Hey dude. Late here, but my deepest sympathies. Losing a pet is awful, and she sounds like a lovely dog.

  118. #118 Calli Arcale
    July 6, 2008

    I’m so sorry to hear about this. My childhood dog died of cancer Well, he died of euthanasia, technically. He had it in his spleen. We found out when his spleen ruptured. They did emergency surgery to remove the spleen and check the condition of his abdomen — it was bad. Metastases everywhere. Dogs don’t let you know when they’re hurting, that’s the trouble, so a cancer can get REALLY far before you know about it. He got a few more months before he was so weak he had to be put down. I held his head while the vet gave him the injection…. That was one of the most amazing days of my life. He was in such pain, and then, at such peace. I know, death is not good, and I don’t endorse euthanasia in humans. Too many tricky ethical questions. But for him, at that moment, it was clearly the right choice, and I am so grateful I was able to be there for his final moments.

    *HUGGLES*

    My thoughts and prayers are with you, Orac. Losing a pet is heartbreaking. We know they don’t live all that long, even in captivity, but knowing that really doesn’t ease the pain at all when they do go. They become a part of you.

    “You become responsible, forever, for what you have tamed.”
    — The Little Prince, Antoine de St-Exupery

    “The Little Prince” is a remarkable book. Read the chapter about the fox. It deals with befriending an animal and then having to say goodbye to them.

  119. #119 clheiny
    July 7, 2008

    Sorry to hear that. Give Echo a scratch for me.

  120. #120 Rev. BigDumbChimp
    July 7, 2008

    I’m really sorry to hear this Orac. We’ve gone through two rounds of cancer with our Lab. Multiple tumors removed with massive surgery. It was tough. Feeling it for you.

  121. #121 Dianne
    July 7, 2008

    Sorry to hear about Echo, orac.

  122. #122 Chris
    July 7, 2008

    I’m sorry for what you are going through. We lost one of our own to squamous cell carcinoma. The cancer showed when she was quite young, however, we were able to treat it. Belle lived several more years until the cancer came back with a vengeance. Enjoy your remaining time with Echo. She looks/sounds like a wonderful dog.

  123. #123 dan
    July 7, 2008

    would LIFT work in dogs? or is there just too much cancerous mass for that to make a difference?

  124. #124 Craig Willoughby
    July 7, 2008

    Orac, you have absolutely no reason to blame yourself. As you said, you are a Human surgical oncologist. You didn’t look at Echo because you weren’t expecting something like this in a dog. I know you feel guilty about it, but you shouldn’t. Save your feelings for her and enjoy your time with her.

    By the way, I said this before, but she is beautiful. WHat kind of dog is she?

  125. #125 BB
    July 7, 2008

    Orac, my heart goes out to your and your family. Tell Echo that Rocky and Skye, a couple of guy smooth-coated collies, wish her the best.

  126. #126 Tlazolteotl
    July 7, 2008

    Orac, I am very sorry. Best wishes to you and your family.

  127. #127 David D.G.
    July 7, 2008

    Aw, man. That sucks. I’m awfully sorry, Orac. My condolences to you and the rest of the family. I know it always hurts to lose a friend, whatever its species.

    :^(

    ~David D.G.

  128. #128 Judi
    July 8, 2008

    Just reading this now. I am so very sorry to hear about Echo, she’s absolutely beautiful.

  129. #129 Jacquie C.
    July 8, 2008

    Orac,
    I hope all these comments are of some small consolation. Echo is such a beautiful dog. I hope your remaining time together is blessed.
    Cancer – I hate it, too.
    ((((((hugs))))))

  130. #130 barbie123
    July 9, 2008

    Orac,

    I am so sorry to read about Echo’s illness. I, too, lost a beautiful, spirited dog to cancer, and, like you, after a needle aspiration of her mass (just like your experience, we had a dog who very suddenly favored one leg/hip) were very hopeful that everything was fine. The subsequent exploratory surgery resulted in the vet calling us in to say goodbye to our dog as she lay sleeping on the operating table.

    Please know that a lot of us share your pain and also share in the hope that you can find some comfort in your time with Echo.

  131. #131 RickD`
    July 10, 2008

    Very sorry to hear about Echo. Lost my cat in February to cancer. It really can be sudden.

  132. #132 Bagheera
    July 10, 2008

    Dear Echo,

    I hope this note isn’t too late, but I wanted to say good bye. I know you don’t want to leave your Humans alone and you love them as much as they love you. It’s in your genes, and probably in theirs too. Our kind and yours have been together a long, long, time, though the time we get together always feels too short.

    Your humans will miss you a lot when you’re gone, but they’ll always remember the joy and love you brought into their lives the way only a Dog can. So when the final sleep comes remember they love you and will always keep some part of you alive in their hearts.

    We all will.

  133. #133 Dr. Dredd
    July 11, 2008

    I can’t even imagine what you must be going through right now. My family has had three bichon frises over the years, and watching two of them go was incredibly hard.

    The Fates are vicious in that they give us 70+ years on this planet while giving our best friends a scant fraction of that time. :-(

  134. #134 wingerx
    July 11, 2008

    I’m sorry to read the news. My wife and I went through almost this exact scenario back in March with our dog, as well. One day, she was her lively, beautiful self. The next, she lied dying on the operating table.

    Being an engineer, I had little to no idea what terms like hemangiosarcoma meant. The vets were all wonderful, and I still don’t know how animal docs deal with it all, but there’s just no easy way to explain “your puppy has cancer.” There’s also no easy way to hear it.

    It’s been almost 4 months, but it’s still shocking to us to come home to an empty, lonely house. At least we’ve stopped going to the back door to let in a dog who isn’t there.

    Our best goes to you and yours. I lament that there’s not more I can do.

  135. #135 Antiquated Tory
    July 12, 2008

    I’m so sorry, Orac.

  136. #136 yttrai
    July 14, 2008

    You have my deepest condolences as well. But you gave Echo a great life, and she loved you in return. You’ll miss her deeply, but remember her as the happy puppy she was, with love.

    I lost The Best Kitty Ever, Vladimir, when he was only 2, to cardiomyopathy. It’s tough thinking “what could i have done” but ultimately, i gave him a good 2 years and that’s the memory i hold dear.

    Thinking of you and Echo.

  137. #137 Kaessa
    July 14, 2008

    I’m so sorry. If I could hug you over the internet, I would. :(

  138. #138 Gordon McFee
    July 14, 2008

    Sorry to hear the news. It’s tough and like some of the other writers, I’ve been there too. Doesn’t help you, I know, but at least you know you are not alone. Remember the good times.

  139. #139 Dirt
    August 7, 2008

    This post made me cry. It is instinctual to want to offer some comfort, but difficult to know what to say. I know from experience that condolences start to lose meaning after you’ve heard so many.

    It is common to blame ourselves when losing a loved one, but like others in this post, I think you should avoid feeling guilty. Your job requires you to focus a lot of attention and energy on the problems of people you barely know, and with a job that absorbing, it is sometimes easy to miss things that are going on in one’s own life, in one’s own home. Like you said, denial is a powerful thing as well. And I think what skeptic sorcerer was trying to say is that hindsight is always 20/20. The present is never quite as obvious as the past.

    Thus absolved of all blame, it is never the less truly ironic that her condition relates so closely to your own area of specialization. I think there is something to be learned from that. You are likely used to giving bad news to people. Being on the receiving end of that news is therefore probably even more of a kick in the pants. I suspect that the next time you have to inform a patient, or a patient’s family, of terminal cancer, it may hold a new meaning for you. To experience personally what you study professionally can only deepen your understanding.

    Like everyone else, I too lost a dear friend. I lived on a farm when I was young and many dogs came and went, but the only one I knew for his entire 7 years was the family’s golden retriever, Jasper. About a year after I had moved away from home, he collapsed one day while playing outside with my sister. They were chasing each other around the yard, and suddenly she realised he wasn’t behind her anymore. And he was gone just like that. My mother had an autopsy done and was told he’d had a cardiac arrest. His cholesterol was through the roof from a life full of yummy table scraps. He was very active and got lots of excercise, and never showed any sign of a problem, so it was very unexpected. But the worst thing was that since I no longer lived at home I had to hear about it after the fact. And then I was so upset for not being around to give him one last treat, play one last game, etc. So for your own sake even more than hers milk every last moment of time left.

    Thanks for your posts, Orac. I discovered this blog a few months ago and I find it truly absorbing. My sympathies for you and Echo, and I hope her passing is not too hard on either of you.

The site is undergoing maintenance presently. Commenting has been disabled. Please check back later!