Last Thursday was my day off. The plan was to tackle a long around-the-house to-do list. I started the day as usual; feed the pets, run, feed horses, clean stalls, and then walk the dogs. I have 2 Labs, 10 year old D.J. and almost 3 year old Blue. I gave them a pet after our walk and my day changed dramatically. I felt a lump under D.J.’s jaw. I felt another one on the other side of his neck and a few more below these. Immediately, I knew I needed to test the lumps, run some blood tests, take chest X-rays but there was only one possible diagnosis for what I had found. D.J. had lymphoma and this was going to end his life.
I felt it all; my heart sank, I had a lump in my throat, my energy faded, my mind filled with too many thoughts.
I had talked the talk many times. Lymphoma is treatable but not curable.
Treatment options include:
• a 6 month multi-drug protocol can results in an 80-90% remission rate and an average life expectancy of 12 months including the 6 months of treatment;
• a single drug protocol every 3 weeks for 5 to 6 treatments for a 70% remission rate and average survival time of 9 months;
• oral palliative chemo every 3 weeks with an average 4 month survival time.
Having talked the talk, I now had to walk the talk and I had no idea what to do.
Is it fair to put D.J. through 6 months of chemo so I can have him a bit longer? Well, pets are supposed to tolerate chemo better than people do. Where would I find the time to get to treatments every week or two? I could probably do some of the treatments myself. An average life expectancy of twelve months isn’t very long. But 12 months means we might have him next Christmas and that is a long way away. We would have spring, summer swims in the pool and autumn bush walks.
With my head far to full of questions, I gave up on my to-do list and took D.J. to the clinic to start the testing. The roller coaster ride this day was going to be continued.
When I arrived at the clinic I was immediately informed that clients, whose dog I diagnosed with lymphoma a few weeks ago had called wanting their dog euthanized that day. She was no longer responding to palliative treatment. They requested me for the appointment but were informed that it was my day off. My associate would be helping them and they were scheduled to arrive at any moment. I was now there and wouldn’t hide. I decided to greet them, take them into the quiet room and explain why I was there. They took the time to give me a hug. I offered to try to do the appointment and if needed my team would assist. I shut down the pet owner part of me and helped them say good bye to their beloved pet.
I needed this roller coaster of a day to slow down.
The next event at the clinic was just what I needed. An internist was scheduled to arrive to consult on a complicated case. I stole a few moments of her time. She palpate D.J.’s neck. “You poor thing.” She also did not need any further testing to diagnose lymphoma. I told her I didn’t know what I was going to do. She put things in very simple terms. I shouldn’t think about a 6 month commitment to weekly visits and $5000. I should just try one round of chemo (3 weekly treatments) and see what happens. One round will show how D.J. tolerates the medication and will determine if the lymphoma responds to the treatments. Decision made. We will try one round of chemo.
I had to remind myself that I hadn’t yet confirmed the diagnosis. I planned to do blood work and X-rays but diagnosing lymphoma meant taking a sample of the lumps and submitting the sample to a pathology lab. I have worked with a local pathologist for 25 years but he recently stopped reading this type of sample. I really trusted his work. I sent him a message asking if he would consider reading this cytology for me. He answered by personally calling the clinic to say he would be happy to help. Without me knowing, arrangements were made that one of my assistants would drive the sample to the pathology lab and he would read the sample that evening so I would have results the next day. The support network was starting to form.
My family was still unaware of D.J.’s condition and the events of the day. That evening we had a family meeting the outcome of which I already knew. The usual decision at family meetings about pets is that since one of us is a vet that member should make the decision.
The report came the next day. It included some supportive comments and the words “no charge” but confirmed the diagnosis of immunoblastic malignant lymphoma. I called OVC (Ontario Veterinary College) Oncology Center and D.J. starts treatments on Thursday. I am expecting another day off full of emotions and questions.