A Bag of Food

I bought the large bag of dog food this time. I want to tell you this right off. I want you to know that I bought a bag of food that should last at least 6 weeks. I want you to know that I trust that Bailey will eat every kibble from this bag, and that I will have to buy yet another large bag after that.

Until now, and with full intention, I have avoided posting detailed updates about Bailey’s health status. But, as Bailey has continued to beat the medical odds for so long, several people have asked for more details about how she is really doing. And all of these requests undoubtedly have come from sincere concern for Bailey’s health, or true awe about her survival. Both are warranted: awe as Bailey continues to be very happy and appears so healthy long past all expectations, and concern as there are nevertheless signs of declining health resulting from both cancer and age. So, for the first time and for whoever is interested, I offer this report on these two realities of Bailey’s health.

Bailey (standing) with two 6-year-old Goldens

It is human nature to give ten times more weight to bad news than to good news. Knowing this, I want to emphasize how amazingly well Bailey is doing—and not just for a dog with a cancer that everyone expected would have killed her months ago, but for any 13-year-old Golden. Most Golden owners that see Bailey underestimate her age by several years. A few weeks ago I shared on Facebook and showed many others the following image of Bailey with two other Goldens. No one guessed that the other dogs are less than half Bailey’s age. But even more important than appearance, Bailey continues to be comfortable the vast majority of the time, she continues to be active even if less than she was a few months ago, and she continues to be interested in and excited by people, food and life in general. Most important, she continues to be very, very happy. Let me say that again and please remember this as you continue to read—Bailey continues to be alert, comfortable, and very happy. This is one of the two realities—the one that led me to buy that large bag of food.

Still, at 13, Bailey passed the median lifespan for Goldens’ nearly a year ago. Plainly put, she is an old girl and, as such, she suffers some of the same ailments as others her age. Her peripheral vision has been narrowing for a couple of years, and the clarity of her focus is now decreasing as her pupils become increasingly clouded. And then there’s the arthritis in her front elbows—the arthritis first noted in early adulthood but which posed no functional issues until it advanced significantly last year, leading to the start of a prescribed NSAID just before the cancer diagnosis. And this therapy was very successful, having produced the near miraculous relief that afforded us that incredible “last” month (Four Weeks), and four additional “last” months… so far!. But as time and age seems to always win out, Bailey’s arthritis has again advanced to the point that her front legs are stiff and unbending most of the time. Stairs have become both difficult and risky, and (whether for pride or comfort) Bailey rarely lets me carry her. After a couple of minor falls, however, she does now wait patiently for me to “spot” her going up and down stairs. And on a few occasions she has reluctantly looked to me to carry her—I still allow her to make this call only because the crestfallen look that always follows saddens me more than anything else we have yet encountered.

So Bailey is an old girl who struggles with some of the same issues that confront most old dogs and most old people. But, Bailey is an old dog with cancer and this makes things less clear. Is the current  symptom du jour just a condition of aging or a seasonal allergy or a routine upset stomach? Or is it the result of a new or expanding tumor? It is simply not so clear anymore.

Bailey’s cancer is spreading. I learned this fact shortly before her 13^th birthday when a chest X-ray revealed two clear nodules in her lungs and a less definitive shadow on her spleen—two organs frequently involved in the course of hermangiosacrcoma. And it would be typical for this type of cancer to have spread even further, but I cannot be sure having opted out of additional imaging since the results would alter neither treatment nor eventual outcome. So, while I have no way of knowing what other organ systems may be involved, the chest X-ray made clear that Bailey’s cancer is spreading. That is one of the few things that has been clear ever since.

Knowing that it is metastasizing, and knowing how aggressive and lethal hermangio’s are, everything out of the norm now has to be seen under the shadow cast by the reality of cancer. Bailey had a bout of repeated diarrhea with some blood in her stool… fear a colorectal tumor but treat as and hope for typical digestive tract upset (which it turned out to be). On occasion, Bailey stares into space and appears disoriented. Granted that she has always been my goofy dumb blond, but she had never previously just stared idly at nothing until jolted by some distraction (usually, the repeated sound of her name leaving my mouth with increasing volume). Hmm… run-of-the-mill disorientation that comes with age, or a brain tumor? And her hearing took a marked and troubling dive in just a few days.  Now, when standing out of her sight, Bailey no longer responds when I call her name or clap my hands unless done very loudly. If within eyesight, she reacts quickly at lower volumes and responds immediately to hand gestures. Yes, this type of hearing loss is common in older dogs, but given the very rapid rate of the decline, it well could be the result of metastasis to the brain—also typical of hermangio’s. Very little is certain anymore.

Indeed, the only symptom that is clearly a product of the cancer is the arrhythmia caused by the tumor on her heart, along with the labored breathing it produces. These were the symptoms that originally made me suspect that something was wrong back in December, and which appeared only occasionally at first.  In mid-March, however, Bailey had the first of two series of very bad days—days when her arrhythmia became quite pronounced and her breathing became labored for extended periods. For several days, she was not at all comfortable and not at all happy—leading to my first serious thoughts about euthanasia (Is it Time?). And while Bailey did recover from this episode, she did not regain her former level of functioning. A new normal had been established in which the irregularity of her heartbeat was itself now regular. Activity would now be limited to no more than a walk around the block, and that only on a very good day. 

June 25, 2013 - Bully stick joy

Within the limits of this new normal, however, Bailey continued to be happy, alert, interested and hungry. And she continued to insist on strolling the 1-1/2 blocks to the dog park nearly every day to interact with both canines and humans—though mostly humans.  Her activity and energy had both declined, but her happiness and interest in life had not.

Three weeks ago, Bailey suffered another series of very bad days. As before, her arrhythmia had become very pronounced and her breathing was very labored—this time, however, disrupting her sleep and sapping her of the breath and energy required to stand or walk more than a few steps. Although her appetite continued to be good and her output normal, she was clearly neither happy nor comfortable, and she was struggling.  By the forth day, I not only considered if it were time, but had decided that if there were no improvement by days end, I was going to bring her to her primary-care vet—not to the urgent care animal hospital for an attempt at treatment, but to the one vet who saw Bailey since near the start of her life, to see to the end of her life.

This time, Bailey must have gotten the memo. She started walking a little more, and her energy and activity continued to rise gradually through the afternoon, the evening, and for the next two days. Based on our prior experience, I was expecting that her recovery would be limited to a new new normal, but within three days, Bailey was back to where she was before. But only for a few days. Then came the periods of disorientation. Then came the rapid decline in hearing. And then came an ongoing if gradual increase in periods of labored breathing.

June 27, 2013 - A little wrestling

The reality is that whether from cancer or age, Bailey’s health is declining and at some point, whether from cancer or an age-related problem, she will die. But, that is just one of the realities. Bailey is truly amazing and she regularly proves that I underestimate just how amazing she is.  She continues to insist on going to the dog park, even if struggling for air and even when so stiff that walking is painful. On occasion, she has even surprised me with a spunky, if brief, wrestle with a puppy, as she did just yesterday. So, one reality is that her health is declining and she is approaching the end of her life. But the other reality is that she still wears a huge smile most of the time, she is still comfortable, she is still interested in life and, most important, she is still very, very happy. 

Oh, and she continues to eat away at that large bag of food.