Ten years ago this month, when she was only two years old, the Brindle Dog developed a mast cell tumour in her neck. I remember very clearly the moment I first felt it, when she and I were playing and I was rubbing and tugging at the sides of her neck. She was wiggling and wagging, and I was laughing. Under my fingertips, I felt a lump deep in the left side of her neck and I thought that’s weird, I don’t recall that dogs are supposed to have a bump there, and at the same time I was reaching for the other side to see if it was bilateral. No, it was not. No matter how hard I poked and prodded, I could not find a corresponding lump on the right side, and my heart sank. I felt a deep fear in my belly and called the vet right away to make an appointment.
A veterinary surgical oncologist removed the malignant tumour, but due to the amount of structures in the neck, the margins were not as clean as desired. My then-partner and I were advised to send her to Saskatchewan for a month of radiation treatment during which time she would be fostered, undergo general anaesthetic every day for the radiation treatment, and require intravaenous feeding because her throat would be burned from the radiation. We elected not to do this. Our reasoning was that even if we could afford to follow this recommendation, we felt it would basically amount to torture for our good dog. How can you ever explain to a dog why they’ve been sent away from home, why every day they are drugged and groggy and nauseated, why they are being burned and cannot eat? We could not imagine it. It felt to us like a selfish thing to do, and at the same time a terribly wasteful thing to do. In a city where children lack mittens and warm boots in the killing cold, in a province where children are still living without running water, in our own lives when at that time we both earned barely more than minimum wage, we could not justify the expense.
So we waited and hoped. We fed her well, and exercised her well, and loved her well, and felt her all over—all the time—for new lumps. Seven months lump-free would mean remission, we were told. Seven months came and went. Her third birthday came and went. She continued happy and healthy, and we were relieved that we had dodged that bullet.
In the intervening time, especially in the last few years, she has developed lots of other lumps. Lipomas and skin tags and warts and ingrown hairs, and lately a particularly ugly papilloma that looks like a mini raspberry or a bright red beer nut (my bromate: “Oh god, I’ll never eat beer nuts again!”). I’ve had many of them checked out by the vet, and a couple of them have undergone fine needle aspiration for a closer look, but it has always been just fine.
But this month, ten years later, it looks like my beautiful Brindle Dog has another mast cell tumour.
I found it while we were playing. I was massaging her back and scritching the base of her tail and squeezing her muscular thighs when I felt a lump in the back of her left thigh. It was under the skin, not on it. It felt like the top half of a golf ball, with the bottom half buried in her muscle. I felt that deep fear in my belly, that sick, sinking feeling. Usually, when I find a new lump or bump, I do worry. But that anxiety is all in my head and chest, high up and tense and quivering until I get some reassurance or just calm myself down. But this deep dread was like the first time, ten years ago, the sure knowledge that this was Very Bad.
Of course, I tried to talk myself out of it. Don’t be silly, just a lump, probably just another lipoma, maybe a cyst, could be anything. But I was scared. So I made an appointment to see the wonderful Dr. Beggs. She did a fine needle aspiration and took the sample for examination. When she returned, she was not smiling. She advised that it would be best to send it off to the veterinary lab for further investigation. She did not reassure me or pretend it was going to be okay.
The cytology report came back two days later and was not encouraging. It looks very much like the Brindle Dog has a mast cell tumour. To know for sure, I would have to consent to a biopsy of the growth. And if she’s going under sedation anyway, they may as well biopsy the lymph node in her knee as well. We would do this along with an ultrasound and xrays to determine whether or not there are already other tumours. If there aren’t, then we could proceed, if necessary, to removing the tumour, followed, if necessary, by radiation—which is only available in the next province.
I know these things. I know the biopsy is crucial to determining what kind of tumour we’re dealing with, and I know that early removal and follow-up treatment is crucial for the long-term prognosis.
But here’s the thing. My good Brindle Dog doesn’t even know she’s sick yet. She is a twelve-year-old Dutch Shepherd who is aging well. Despite her cataracts and her gradual hearing loss and her general slowing-down, she still believes she is in the prime of her life. She hasn’t noticed the tumour. Sure, she needs a boost to get into the car and sometimes she stumbles on stairs or in the dark, but she takes it in stride and just keeps trying. She is always willing to chase a stick and bark at a squirrel and fling herself onto the floor for a belly rub. Sure, the flinging is a little more careful, and she gets tired more quickly during the stick-chasing, but the point is that she wants to and is able to play. Her tail still wags a mile a minute. She is HAPPY.
But if I decide to take her in for the biopsies, then basically her life starts ending now. Now would be when the pain starts, and the fear, and the abandonment at the vet clinic. The stress and anxiety. Stitches and recovery and drains and the Cone of Shame. If it is indeed a mast cell tumour (which seems quite likely from the cytology report), then we are going to have to remove this lump from her thigh. The part I can feel is not quite as big as half a golf ball. But who knows what’s underneath? Is it a neat round ball? Or is it tentacled? How much thigh will she have left once the minimum 2cm—preferably 3cm—margin of tissue around the perimeter of the lump is removed?
How, then, will she chase a stick?
The Brindle Dog is twelve years old. She is happy. She doesn’t know yet that she is sick. Her tail is usually wagging. She is fully engaged with her own life, with me and the Fluffy Dog and the cats and the other people who live in this house, and our guests, and the neighbourhood. She has her habits and routines and preferences.
She is getting old. Her dwindling eyesight and hearing mean that she gets more easily anxious. She has always wanted to be close to her humans, but now she is more nervous about being away from me. She needs more reassurance after loud noises or unexpected events. She now has to depend on the Fluffy Dog to alert her about distant noises, which means her role is changing. It’s my job to take care of her and help her navigate these changes.
I don’t want her to live as long as possible. I want her to live as well as possible.
So after discussing it with my ex (who was always, everything else aside, a good and loving papa to the animals), and after consulting with my own heart and instincts, I have decided not to do any invasive interventions. Not to do any interventions at all, actually.
Right now, she is happy. And when she starts getting sick, there is a lot we can do for her. My vet is on board with the plan to simply provide the absolute best palliative care. As soon as the Brindle Dog becomes symptomatic, we will jump in and address them. And meanwhile, I am trying to get in to see Dr. Linda Hamilton for some advice on supporting my old girl’s health starting right now. Because I have declined to do a more thorough investigation into the nature and extent of the problem, I don’t know how much time the Brindle Dog has left. It could be six weeks, but it could also be a couple of years. But because she is still doing so well, I am hopeful.
I’m a mess, of course. Sometimes I just start crying out of the blue, and most of the time I am distracted and kind of absent. I try hard not to cry around the Brindle Dog, because it upsets her, so that’s a little tricky. But I am no longer second-guessing myself. I know right down in my cells that this is the right course of action for her. To paraphrase Trooper, she’s here for a good time now, not a long time.
Right now, she’s happy. She’s having a good time. And I’m going to do my best to keep it that way until the day I hold her close while she is helped gently into the kind darkness that waits for all of us.
(Edited 01 March 2016 to fix a couple of typos and straighten out some crooked wording.)