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Good-bye, Zoe

September 9, 2010

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“A dog doesn’t care if you are rich or poor, clever or dull, smart or dumb. Give him your heart and he’ll give you his. How many people can you say that about? How many people can make you feel rare and pure and special? How many people can make you feel extraordinary?”
– From the movie “Marley and Me”

Zoe passed away a week ago today in her own home, surrounded by family who loved her.  Although we had only 9 months after the amputation with her, they were all in all happy, active, wonderful months, and if we compute it out into people-years, it’s another five years of life.  And boy, did we make the most of them.

I’m not really emotionally ready to type out much more than that right now, but just wanted to say a deep, heart-felt thank-you to all of you at tripawds for your endless encouragement and understanding.  We miss her like crazy, and are still weepy daily, but know that she will always still be with us in our hearts.

Thank you for your endless love, you beautiful, silly girl.


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I do not have the energy to type a long post but wanted to quickly update.

Zoe is curled up by my feet, sleeping fairly comfortably as I type.  She has declined pretty fast the last few days, though it has been a roller coaster.  I did go ahead and put her on Tramadol, as she was really shaking all the time pretty badly and struggling to breathe, and there were a few days that I had to help hold her up to go to the bathroom.  On the night before I started Tramadol, there were a few times she paused her breathing and I counted to a slow ten before she breathed again, while the adrenaline rushed to the pit of my stomach.

Rich had been out of town and it was hard knowing how badly she was feeling and I was hoping I would not have to make any tough decisions with him gone and say goodbye without him here.  I didn’t ask him to come home, but he heard my worry in my voice, and called me the next morning, saying, “I am on my way.  See you in twelve hours.”  I do love that man.

The Tramadol helped a ton, especially the first day.  She was up walking on her own again, and the shaking had slowed down.  I laid with her in the sun outside in the backyard, I took her on drives with all the windows rolled down, and I cuddled up with her on the couch.  But then the next day she was slower and rougher.  She is having trouble walking again.  She refuses my touch sometimes (which is tough when I need it, but I am respecting her feelings), and is starting again to eat less.  I asked her if she would like to walk down with the mailbox with me (about 4 houses down), and she seemed interested, but then only could walk about 100 feet until she stood in the middle of our street, staring at me, saying, “Mom, I just cannot take another step.”  I took her back in and tucked her back on her bed, where she has spent pretty much every moment since her decline (if she is not on the bed with me).  I worried again – is this it?

The next day, more of the same.  Rich came home from work and wondered as well.  I had to take the kids to swim class, and he stayed with Zoe.  Then he decided to do a little test.  “Wanna go?”  And she did.

I got a text while I was watching the kids swim – A picture of Zoe standing in river water, sniffing clumps of grass.  I guess she stayed out there for about 15 or 20 minutes, exploring, then walked back to the car and was ready to go home.

Then last night my mother-in-law came over to visit Zoe, and she barked at the door and gave her a whine greeting and licks on the face.

I too am trying to learn the lessons from my dog.  Live in the moment.  Rest if you need to between the moments of joy.  And when it is time to be joyful, don’t hold anything back.  Last night’s answer?  This health-food, organic/local, farmer’s market and gardening girl had potato chips and ice cream for dinner.  It’s back to health today, but I needed it.

I talked to our vet this morning when she called to check on how we are doing.  I let her know her symptoms, and I she suggested that we need to start thinking about making a decision.

There are still moments of life in her – we’re embracing those and giving her chances for more if she wants them, and keeping a watchful eye on her so she can communicate with us what she needs.  And we’ll be for her, in whatever way she needs us, even if it isn’t the kind of help that is easy for us to give.

It’s been seven months since Zoe’s amputation, and just when I was sure Zoe had kicked chondrosarcoma’s tail, we find lung mets.

We had gone on a trip out of town for a week to Disneyland with the kids, and left Zoe in the very capable hands of our professional pet sitter.  Yet when we returned, Zoe seemed markedly different to us.  Her activity level had gone way down, she wasn’t eating all of her dinner, she was noticeably thinner, and she was shaking off and on during the day with labored breathing, most noticeably in the mornings.  I had a strong suspicion we were dealing with cancer’s return, but we took her to the vet to confirm, and the x-ray told the rest of the story: the beginnings of cancer in her lungs.

Strangely, on the whole, we are dealing with the news pretty well – we’re feeling at peace with what is going to happen most of the time, with some normal worry about Zoe’s experience of everything and making the right decisions for our family some of the time.  We’ve had time to prepare for this possibility.  We’ve been through the grieving process with regards to Zoe’s health already, to some extent (though, of course, we haven’t been through the finality of this journey and don’t know what the rest of it holds for us).  And we’ve had an exceptionally wonderful last seven months with her: car rides with all the windows rolled down just for the fun of it, feasts of rice and chicken and stew and potato-vegetable-gravy-meat birthday cake prepared especially for her, camping trips where she ran on the beach and tasted her first salt water, and family pile-ups on the bed with Zoe squarely in the middle, giving her pack-animal style gratitude, complete with howls, purrs, rubs and kisses.  The amputation gave us the ability to tell her “thank you”.

I happen to work in a profession where I help people make one of life’s greatest transitions – through birth.  I know I have some skills to help Zoe make her final life transition to death, when the time comes.  I’m a birth doula, which is a non-medical support person, sort of like a birth “coach”, who provides physical comfort and emotional support to women and families through labor and birth.  Birth and death – both intensely physical and emotional processes that transition you to a new state of being.  They are two sides of the same coin.

My plan, as of right now, is to let Zoe lead, just as I let a woman who is birthing lead.  She’ll tell me when it is time for help with comfort (pain meds or more holistic measures), or in death’s case, for euthanasia.  Or perhaps Zoe will choose to pass through life’s last gate without any assistance, naturally.  I am not attached to either outcome.  This is HER death.  I will let her call the shots, as well as I can interpret them.

I will watch her carefully for signs that she wants comfort and company, or wants quiet and solitude.  I will offer food and water, activity and games, touch and love, but not force them upon her.  I will allow her to flow, like a river, however she needs to flow.  And I will be the strong banks of the river while she flows, giving her safety, giving her strength, yet not forcing change in direction or speed.

I also know a way I can help her, just like a woman in labor, is to match her rhythm.  If I pet her (if she is wanting to be pet), I will stroke her with the rhythm of her breathing (or her vocalizing, if it comes to that).  Just a small thing that in my experience makes a world of difference to a laboring mother – my hope is that it will be reassuring to Zoe as well, and maybe on some level give her permission in comfort to follow this natural body process to its culmination.

Yet, though I have some things I can bring to the table for Zoe, death is new for me.  I have a lot of questions.  So I’m coming here for your help and support.  Here are things I am wondering if my fellow angel tripawd guardians can help me with:

  1. What was the physical progression of the disease like for your dog from learning about the lung mets to the end?  I’m wondering about what I can expect with regard to symptoms, behavior, etc.  We were given a rough estimate of one month if she has fast-growing cancer to six months if it is a slow growing type.
  2. If you did (or did not) decide to give pain medications, what type did you use and what was your experience with those drugs?  How did you know you wanted to use them (or not use them)?  Did they affect your dog’s awareness of her surroundings or ability to interact in a meaningful way with family members?
  3. Did you do any non-medical comfort measures, such as acupuncture or pet massage, or anything else?  How was that for your dog and your family?
  4. Our vet already verified that at-home euthanasia is an option for us.  For those of you who chose euthanasia, what was that experience like for you and as far as you could tell, for your dog?  This may seem morbid, but what was the physical reaction in your dog when the medicine was given (any jerking, noise, etc? We are trying to decide if our children could handle being there for her passing if they wish.) How did you know it was time to euthanize?
  5. Did any of your animals pass without euthanasia, naturally?  How was that process, for you and your family and for your dog (as well as you could tell)?  What were the signs that the end was near, and how long did it take?  If you have human children, how did they handle it?
  6. What did you choose to do with the remains?  And what did it cost, if you don’t mind sharing?

Just trying to work out a care plan.  Thanks for any information you can provide.

Kristina

Four months!

April 9, 2010

I wanted to come here and offer a quick update.  Zoe is doing GREAT!  I don’t have time to write much, but I wanted to post something here that might offer hope to anyone considering an amputation for chondrosarcoma.

After the surgery, we were told that Zoe’s version of chondro was a more aggressive form than most, so there is a chance that it might spread after surgery, though that isn’t common among this type of cancer. However, we were given a 70% that it won’t!  Gosh, I’ll take those odds!

We were offered monthly scans for lung mets and low-dose chemo, but we decided that with the odds so in her favor, we don’t want to put her (and us) through any more medical stuff.  She’s always had a weak stomach. If it had been more aggressive, we might have more seriously considered the chemo, but chondro doesn’t respond well to chemo anyway, and it might have made her feel sick for no benefit.

But I’d put money on the bet that we got all the cancer.  And that’s due to something silly – her little wet nose.  Many months before her surgery, even before the lump, her nose was always dry.  Now it’s always cold and wet – a sign of dog health.  That wet nose gives me so much hope.

Zoe still needs help up onto the couch, walks for shorter distances (her remaining rear leg has pretty severe hip dysplasia) and does a little head-bob when she walks now, but she is adjusted very well all considering.  She’s happily keeping up with the kids and is enjoying life to the fullest.

And we are enjoying her to the fullest, too.  I’m sure so many people here understand what it feels like to have a dog with cancer – you just don’t know how much time you have left, so you make sure to cuddle a little longer, give more kisses, spoil a bit more than you normally would.  It’s given us a wonderful bond with her – and she lets us know she appreciates it when she jumps on the bed in a pileup with all her family members and does a loud whine/moan routine (a new trick!) while we cuddle with her.

Zoe means “full of life” – and she certainly is.  We couldn’t be more thankful she’s still sharing hers with ours.

A quick update to let you all know that Zoe is doing very well a week and a half post-op.  I knew she was doing well when just a few days post-op she decided it would be a great idea to go outside and bark at a squirrel on the fence!  Of course I reigned her in as soon as I knew what was happening – she may be ready to go, but mom would like her to take it easy a little while longer.  She also enjoyed a short, slow hop down to the mailbox with me to collect the mail, one of her favorite activities she enjoyed before surgery.  And we’ve been enjoying lots of cuddle time on the couch.  This morning, when preparing my daughter’s bath, Zoe wandered in and looked at me like, “please? can I get one too?”  That’s VERY unusual behavior for her – but darn cute.

The other major event this week was Zoe’s dad, Rich, deciding to grow a lump on his rear right leg, too!  Holy sympathy pains, Batman!  It turned out to be an overactive gland right underneath his kneecap that had grown to the size of a silver dollar and had gotten infected, making it hard to walk.  (Too much information?)  We’ll take that over a sarcoma any day.  No amputation for him, but he did require a minor surgical procedure that ended up having more pain than any of us realized.  I’m a birth doula by trade, and when he came home from the procedure and the numbing shots wore off (no one gave him any pain meds for home) I needed to use all my comfort measures and birth experience to basically carry him back in to the office for a re-do of his knee.  They had packed it very tightly and didn’t give him any pain meds for afterward.  Cold sweats, almost throwing up, moaning, the whole bit.  This coming from a guy who can usually handle pain just fine – so you know it was bad.  Poor guy.  I have to admit, it crossed my mind to give him a Tramadol from Zoe’s stash (kidding, people).

So I had two hopalong family members on the mend this week.  Please, no more leg lumps for a while…

I uploaded a little video on youtube showing Zoe six days after surgery.  In the background is Rich, getting into the truck to go to his “little” knee procedure, unaware of the drama about to unfold.  I tried to catch Zoe moving around a bit.  I did video her going to the bathroom – I know, too much information again! – but thought it would be helpful for those of you who want to see what to expect with a rear leg amputee.  This is right after we were experimenting with letting her go on her own without a sling under her belly, but as you can see I needed to stop the tape at the end to help steady her for pooping.  Now she’s nine days out and peeing and pooping fine on her own.  Yea Zoe!

Zoe, 6-days post-amputation

We drove up to Pullman to pick up Zoe from the WSU vet hospital on Sunday morning, not really knowing what to expect, except that she was “confused”, “doing really well”, and that things are still “gory” and to be prepared for that.  I had visions that I’d find her looking like an alligator ripped off her leg – but things were much better than I had anticipated.  Though afterward, Rich made the comment that things are both better and worse than he expected, which I would agree with.

First, the “better”:

As she bounded out to greet us, it was apparent that she was feeling MUCH better than before the surgery.  Some pictures, to illustrate:

A FEW DAYS BEFORE THE SURGERY:

DSC_0623

3 DAYS AFTER THE SURGERY, EVEN ON PAIN MEDS:

DSC_0631

These pictures really don’t do it much justice as she’s laying down in both, but I can tell that in the first photo, she had very little life in her eyes.  She pretty much found one place on the couch that made her as comfortable as possible and parked there for a couple of weeks, only to get up for food, drink, or to go to the bathroom.  Now, she seems more interested in the goings-on around her, and more curious and lively – happy to interact with us.  It is amazing to think that she already presumably feels better after the surgery – that cutting off her leg could actually feel better than the pain before it.  It makes me realize how much she must have been hurting.

Also, things are MUCH less messy than I expected.  There is a large bandage wrapping her lower torso fairly completely, so I know that is masking a lot of the gore, but they let us know there are no drainage tubes or anything like that, and that we really don’t need to worry about much mess of blood or otherwise.  Things are obviously swollen and bruised, but all in all, things look better than my alligator attack mental picture.

Here’s a picture of her bandage – you can see some bruising and swelling poking out, but still much better than I imagined:

DSC_0633

She’s looking a little annoyed that I lifted her covers to take a picture.  Ha ha.  But all in all, not bad looking. Yellow looks good on her!

The “worse than expected” is that she’s less graceful on three legs than I had imagined she’d be.  The Weimaraner appears to be such a regal, distinguished breed.  But at least for Zoe, that outward appearance is somewhat of an allusion.  She’s all sleek and beautiful on the outside, but she’s always been a bit of a klutz.  It’s actually one of her most enduring, lovable traits.

P7230010We remember her trying to learn to swim as a youngster – her head would dip ever so slightly as she doggie paddled, and a little water would get into an ear.  Then she’d decide to shake the water out – while still swimming – which of course is a bad plan.  This only got more water into her ears, and made her head dip further into the water, and she’d quickly make a 180 in the water, heading for shore.  What a goof.  But she was always up for trying again.

So we’re laughing at ourselves that we were surprised to see her struggling a bit with walking. Yet we know that this is temporary, and she’ll learn quickly.  We see her puppy days again.  She’s always been a fast learner.

For now, Zoe wants to rest a lot, but wants to be in the same room with us, which wasn’t always the case pre-surgery.  Upon many of your suggestions, we’ve made a couple of mobile beds on the floor for her out of egg crate style mattress toppers and blankets.  Even then she does occasionally want to be up on our couch or bed with us (they are both low-profile), and we’re happy to help carefully hoist her up, upon the vet’s approval.  She still spends most of her time on three legs eating, drinking and going to the bathroom, and tires early.  And we’re using a heating pad on low for those tired muscles as suggested, too.

Last night she also had the motivation to come into the kitchen and dining room with us when we were preparing dinner and eating, trying to scrounge for dropped treats under the kids’ barstools.  We’re not about to let a morsel fall after all the pancreatitis and liver issues, so she eventually pooped out to lay down on the tile.  Tile is something she’s normally way too good for – why lay on cold, rough tile when carpet and couches are nearby? – but we’re taking that curiosity as a great sign.  Even though it’s hard, she’d rather be with us, and the thought of a dropped noodle or piece of chicken is worth the effort of trying to hop around.  That tells us that she’s motivated to get over the uncoordination of being on three feet.  And what a reward that is – we already so impressed with her and know we made the right decision.

Zoe, you continue to be an inspiration.  We are so very proud of you.

Zoe’s joining the club!

December 4, 2009

After getting our surgery pushed back a day due to a couple of emergency surgeries (we were happy to let that happen as we know they would have done it for us), we went up to the WSU vet hospital this morning.  The morning was spent perusing our old college town, taking a hike that was a familiar path to us up Kamiak Butte (and a hike that Zoe would love), and just trying to keep our frets to ourselves, we got the call – Zoe’s lungs were clear of metastasis!  Emotional me burst into happy tears in the middle of the coffee shop (also called Zoe, actually) and then we drove home and picked up a favorite bottle of wine to celebrate.

DSC_0626Some of you folks might recognize this bottle from an earlier post by Jerry, here.  Ironically,Three Legged Red by Dunham Cellars of Walla Walla always been a favorite of ours, and from a winery about an hour away.  Anyone want to come by for a winery tour?

Her liver handled the surgery beautifully – that was my main worry since her numbers were still a little high – and she’s sleeping in a morphine-induced haze right now.  WSU vet hospital is wonderful for communication – we get a call for an update generally once in the morning and once at night.

Boy, are we feeling very thankful right now.  And thank all of you for all your support.  We are incredibly grateful and words don’t really describe how we are feeling about all of you 🙂  Really, just knowing so much of you have been through all this and are glad you did means the world to us.  We’ll let you know more when we have her back home, which should probably be on Sunday.

Kristina (Zoe’s mom) and Rich (Zoe’s dad) and Zoe’s unfurry siblings, Connor (7) and Siena (4 1/2)

…and some pics.

December 2, 2009

Some of you asked for pictures of our little girl.  Here are some:

surgery day tomorrow

December 2, 2009

Tomorrow, at 7:30 am, we’ll be taking Zoe in to the university hospital for probable amputation.

Zoe’s liver values have improved quite a bit – she’s still not quite in “normal” range, but because her tumor is growing so quickly, the vets are recommending surgery as soon as possible.  However, we’re doing a CT scan first of her lungs – if the cancer has already metatised, we’ve decided to go ahead and take her home and just love on her and make her comfortable for as long as she’d like to be with us.  If the lungs are clear, she’ll go straight in to surgery.

There are so many memories I have of that strong leg.  Her jumping up and tearing off the red bows – just the red bows – off the christmas tree, and leaving only the ones she can’t reach.  When lightning struck very nearby when we were camping with her, her jumping (or really, almost levitating) into the bed with us, after she couldn’t seem to jump that high.  Her standing like a human at the kitchen counter, trying to reach goodies (and sometimes succeeding when we weren’t looking).

We took her for a hike over Thanksgiving, and again yesterday.  Funny girl, walked just a bit down the trail, then turned on a dime and walked back to the car.  But she was just so darn excited to be there!

I’m so glad we’ve had this time together this week to love her.  She’s sleeping in bed with us tonight (an unusual treat) and then very early we’ll make the drive up.

I do have questions….

…what should I expect for recovery on a hind leg?  Anything I need to do beforehand to make her recovery more comfortable?

…will she be able to go to the bathroom on her own right away?

…how long will she probably stay in the hospital?

Positive thoughts for no metastasis….

Introduction

November 27, 2009

It’s thanksgiving, late at night.  I sit here typing as our lovely 9 year old Weimaraner, Zoe, is curled up on the couch.  We have been through a lot over the last month. 

It all started with a day where I came home to find several piles of doggie vomit on the carpet.  All in all, not all that unusual – she’s always had a weak stomach – but this was more than normal, and over the course of the day, I noticed she wasn’t keeping anything at all down.  Then, while checking her out, we found a golf-ball sized lump on the back of her leg.

The throwing up spell ended up being a case of pancreatitis (which was odd as she hadn’t gotten into any fatty food or anything), and the golf ball lump “looked suspicious”.  I tried not to think about the lump and stayed focused on getting her pancreatitis feeling better.  A couple days on an IV at the vet and a low-low fat diet and she was lively again.  We took her home, and scheduled an aspirate of the leg lump in a couple of days.

Aspirite day came, and I noticed that the insides of her ears were yellowish…as were the whites of her eyes.  And she was shaking.  We took her in, and what was supposed to be aspirite day ended up being liver issue day.  I was so worried the (probable) bone cancer had already spread to her other organs, or perhaps the cancer had started somewhere else in her body and was now spreading all over and to her leg.   A couple of days at our vet, then a transfer 2 1/2 hours away to a college veteranary hospital (a very good one) and lots of tests, biopsies, sonograms, etc….

Finally we have our diagnosis.  And all in all it is quite promising.  The liver issues?  Brought on by the bout of pancreatitis, and all organs appear clear of cancer.  The leg?  Biopsy came back as chondrosarcoma.  Bone cancer, yes, but less likely to spread if we amputate (I think we have an 80% chance of being all clear after amputation).  So amputation is a no-brainer.

The only problem is that her liver is not yet healthy enough to complete the surgery from the unrelated pancreatitis/liver attacks.  Anesthesia clears through the liver, and we’re just not ready for that yet – in fact, it may be another month.  So I’m scared.  I’m scared that the cancer will spread while we wait.  I’m scared as our golf-ball sized tumor has turned into a half-grapefruit-sized tumor in a matter of a couple of weeks.  And I’m scared that my little puppy is in some pretty severe pain, limping worse every day.  But I’m also scared of going ahead with surgery before her liver is ready and losing her on the operating table.

But more than I’m scared, I’m thankful.  I’m thankful that a diagnosis of chondrosarcoma gives us a decent chance at beating this thing.  I’m thankful for our vets who have taken so great care of Zoe and have called every day to report progress (or get reports from us).  I’m thankful for every day, every moment, that I have with my first child, my furry one, my passionate and loving and utterly amazing animal.

Happy Thanksgiving, my little pup.  YOU are who I am thankful for this year, more than ever.