Regression and a Big Decision Today

Despite having a really good Sunday evening, Monday, and Tuesday morning, when I got home from work yesterday evening, Lexie had regressed.  She didn't want to eat anything, not even hot dogs, and she was very weak.  A little later in the evening, she finally went into the kitchen to drink some water.  She drank a TON of water, actually, but then she staggered into the living room and threw up all the water she had just drank.  Justin tried to tell me that she probably threw it up simply because she drank so much so quickly, but there was no consoling me.  I knew that none of this was good.

We decided to sleep in the living room with Lexie last night because she had started moaning and groaning a bit.  Mind you, Dobermans are known to be big whiney babies, especially when they're wanting some attention, and this is definitely true with Lexie.  However, Justin and I didn't sleep all night because we each took turns laying in the floor, spooning Lou and trying to comfort her.  No matter how much we cuddled her, though, she continued to moan and groan all night long. 

Finally, around 5:00 a.m., I tried to give her two Tramadol pills for pain.  She wouldn't open her mouth for me, but I managed to pry her jaws open just enough to slip the tablets into her mouth.  A few minutes later, she spit them out.  We did this a couple more times before she finally swallowed them.  I thought that the pain medication would at least knock Lexie out so that maybe Justin and I could sleep for a half-hour before we had to get up for work, but she still continued to moan and groan.

At that point, I felt that it was probably time to end Lexie's suffering.  It just so happens that she already had an appointment with Dr. Ellis this morning because she's supposed to have her stitches removed today (such cruel irony).  So, I texted Zach, Kristy, and my mother to give them all the heads up that Lexie may not be coming home from the vet today.  Zach and Kristy both came over to say their potential good-byes.  I asked Justin if he would be willing to help me take Lexie to the vet because I wasn't even sure at that point if she was able to walk.  She had barely moved a muscle all night long.  However, when I asked Lexie if she had to go pee, she actually sat up.  She even managed to stand up, although she was very unsteady, probably due to a combination of the pain medication making her loopy and half of her body being asleep from not moving all night.  Regardless, she managed to find her way onto the porch, then down the front steps and into the yard to pee.  She even got into the car all by herself.

Normally, I'd be very happy about those things, especially with Lexie getting into the car independently, but all it did was make me even more confused about what I should do.  On one hand, I know I'm going to have to euthanize her eventually, no matter what, and I certainly don't want her to suffer if she's in pain.  On the other hand (and I realize I'm probably just trying to convince myself of this), I keep wondering if her backslide yesterday evening and all the moaning last night were reactions to stopping her pain medication cold turkey.  (We stopped giving her the Tramadol after her Monday morning dose.) 

The reason I'm having such a hard time just "letting go" right now is because I want SO BADLY to be able to give her at least a few happy days after being fully recovered from her surgeries before it's time to finally say good-bye.  When I told this to Kristy this morning, she said, "But you have given her a LOT of good days.  She's lived a very happy life."  I know this is true, and Kristy makes a good point, but I just hate with all my heart the thought of Lexie going through all this pain and misery, all those trips to Ohio, those long, overnight stays at MedVet, and THREE surgeries, only to finally come home and be euthanized before her stitches are even removed.  I mean, what was the point of any of this?!?

People also keep telling me not to beat myself up and that I made the best decisions with the information that I was given at the time.  I know this is also true; however, that doesn't make any of this easier for me to accept.  It doesn't stop me from being SO ANGRY over the fact that I was told Lexie's abdominal ultrasound showed no signs of cancer, which was the reason why I decided to let her have the enucleation surgery in the first place.

Speaking of that, I sent Dr. Kennedy an email full of questions yesterday, to which he replied yesterday evening....from his iPhone.  I am now going to copy and paste the questions I emailed to him and his answers for you to read (I have not altered this text in any way, other than highlighting his responses):

1. Could you please tell me again exactly what Lexie’s cancer diagnosis is?  I tried to take notes while we were on the phone, but all I wrote down was “vascular and lymphatics,” “inflammatory mammary carcinoma, “Stage III,” and “50/50 it will return in 12-15 months.”  Obviously, I should have taken better notes, but I was in a combined state of shock and devastation at the time.

Mammary carcinoma

2. You mentioned on the phone that the size of the two mammary tumors removed during Lexie’s surgery were quite large, and you said this was “concerning.”  I actually have a few questions regarding this:
   1. How big were the tumors? Over five cm
   2. Why is the size of the tumors still concerning if they were removed? Because we could not take the amount of normal tissue desired to be sure all cancer was removed
   3. When you first mentioned the possibility of removing Lexie’s swollen mammary glands on July 7, 2012, because you said the tumors could be cancerous, I informed you that Lexie had just recently had an abdominal ultrasound, which I was told showed no cancerous tumors.  At that time, you explained that it takes billions of cells to form even a small tumor that is visible enough to be seen on an ultrasound.  If that is the case, and the two tumors removed during Lexie’s surgery were so large that you find them to be concerning, why weren’t they visible on her abdominal ultrasound performed June 20, 2012? The statement about the cells refers to x-rays. I do not know what to say about the presence of the masses at the time of the ultrasound. There is always some mixed inflammation. In these rumors and that might be why they were so obvious to me.

3. When you said that there is a 50% chance that another tumor will appear within 12-15 months, does that mean that the two tumors that were removed during Lexie’s mastectomy were the only cancerous tumors she had?

The only ones we could detect. It is likely that more will form in others glands or within our surgery site

4. You mentioned something about further tests being done on the tumors to see if any lymph nodes were also removed during surgery.  Could you please re-explain the reason for this?  Also, when do you expect to have the results of these additional tests? We submitted a mass of tissue. The lymph node should be in that mind of tissue. If the pathologist finds it he can assess any sites for metastasis (spread) as this will worsen her prognosis if found.

I do not know when to expect it back but hopefully by the end of this week

5. Does Lexie have a life expectancy given her recent diagnosis?

 Potentially as little as 5-7 months

6. Do you know of any current clinical trials for canine cancer treatments for which Lexie might be eligible?

 not that I'm aware of

I'm a little infuriated by his response to question #2c.  Why would he have answered my question about Lexie's abdominal ultrasound with information that pertained to X-rays?  I am 100% certain that I did not ask him about Lexie's X-rays because 1) her X-rays were not performed at MedVet; they were done at Animal Care Clinic in Huntington, and 2) When Dr. Kennedy called on July 7 to discuss Lexie's swollen mammary glands, I mentioned her abdominal ultrasound to him because it had just been performed at MedVet two weeks prior, and I was told that the ultrasound did not show any cancer.  I didn't mention Lexie's X-rays to him because they were X-rays of her chest, not her abdomen.

Anyway, I know that what's done is done and that going over all the shoulda, woulda, coulda's isn't going to change anything, but I just feel so...wronged.  While I can accept that Lexie has cancer and will eventually need to be euthanized, possibly even today, I simply cannot accept the fact that the veterinarians at MedVet missed two Stage III mammary carcinoma tumors that were both over 5 cm in size, nor do I find Dr. Kennedy's reply of "I do not know what to say about the presence of the masses at the time of the ultrasound..." to be acceptable in the least.  I plan to call MedVet today to request a copy of Lexie's medical records, including her ultrasound images.  If another veterinarian looks at Lou's ultrasound and tells me that they do not see cancer, then maybe I will stop feeling so angry. 

In the meantime, Lexie is currently at Animal Care Clinic, and I am waiting for a phone call from Dr. Ellis so we can discuss Lexie's current condition and whether or not she should be euthanized today.  If Dr. Ellis tells me that Lexie's behavior yesterday evening and last night were a result of the sudden medication withdrawal or possibly some other explanation, and if she thinks that Lexie's still got a few good, pain-free months left in her, I will probably choose to bring her home.  If Dr. Ellis tells me that Lexie is in pain due to the cancer, I will not make my Lou suffer any longer.

Blind Dobe Preparations

I know this is going to shock you guys, but last night Justin and I decided that we'd rather pick Lexie up tonight than wait until Saturday morning because we don't want to spend half the day driving to and from Ohio tomorrow.  We'd rather get home really late with her tonight so that we can have ALL day tomorrow and Sunday to hang out with her at home.  So, I'm going to pick up my Lou tonight!!!!!  

I don't know if you guys remember this commercial, where the kids are so excited about going to Disney World that they're "too excited to sweep":



Well, that was basically me this morning.  My eyes popped open around 5:00 a.m. and all I could think was, "I get to pick up my Lou today!!!"  I then proceeded to surf the Internet on my iPhone while laying in bed for the next hour and a half, Googling things like "blind dog toys" and "helping your blind dog adjust." 

We've actually been preparing for Lexie's new life as a blind dog for several weeks.  My back deck is basically just an elevated, 6-foot wide, wooden platform with two sets of four steps leading down to the back yard, but there were no railings or boundaries along the edges.  When Lexie first lost her vision, she terrified me by falling off the deck not once, but three times!  It's only about 3 feet off the ground, but that's plenty high enough for her to get hurt if she landed the wrong way.  So, building a railing for the deck became my TOP priority.  The problem is that neither I, Justin, nor any of our immediate family members are very handy. 

So, my good friend, Shane, came to the rescue!  With the help of my brother, Zach, and Zach's girlfriend, Kristy, Shane installed a railing along the edge of the deck in no time.


We decided that I should also put up some lattace along the bottom of the deck so that Lexie couldn't get lost underneath, and the steps also needed some sort of railing or boundary so that she couldn't accidentally walk off the sides.  I had gotten so caught up with Lexie's latest emergency, however, that I hadn't gotten around to purchasing the lattace and lumber yet.

Then, just a couple days ago, I came home from work to find that Shane had borrowed my house key from Zach and Kristy (they live right next door) and come over during the day to install railings on the steps and lattace underneath my deck as a surprise!  I'm telling you guys, I have the BEST friends in the ENTIRE word.  You just don't even know...

The other measures I have taken to help Lexie adjust are:

• I bought all three girls new collars with metal ID tags, which jingle a little whenever they move around.  That way, Lexie will always know where her sisters are.
• I bought elevated food bowls for the girls.  I know that it's best to feed larger dogs out of elevated food bowls anyway, but my girls are all kind of lazy and have always preferred to lay down on the floor while they ate.  Lexie was kicking and tripping over the bowls, though, so I figured it was time we got them off the floor. 
• I purchased textured outdoor doormats and placed one at the top step of the back deck and one at the bottom to help Lexie know when she needs to step up and step down.  I blocked the other set of steps off with a baby gate.
• I read online that it is good to help your blind dog establish a "home base" with a doggy bed, so I purchased one last night.  Mind you, I highly doubt Lexie will use it.  We've had doggy beds before, but Jocie was always the only one who seemed to aprpeciate them.  So, I fully expect Jocie to claim the new doggy bed as hers, too, but I thought it would be worth a shot to see if Lexie might use it when she gets home.  I'm going to have the new doggy bed in the back seat when I pick her up tonight, and hopefully she'll lay on it during the ride home.
• I know Lexie probably won't feel like playing much for the first couple weeks that she's back home, but I'm really hoping that once she's healed she'll get some of her spunk back and we can learn some new games to play together.  She loves to play tug with her stuffed animals (after she gets tired of cuddling them), so last night we bought her a Kong Wubba toy that looks like a cross between a teddy bear and an octopus and has a LOUD squeaker inside (Lexie loves to squeak her stuffed animals at us).  I also bought her a Kong ball, which has slits all around it so you can insert treats inside. I'm hoping Lexie will utilize her sense of smell to find the ball when I throw it.  This will be a new game for us, as Lexie has always prefered stuffed animals over rubber toys.  I'm hoping she'll enjoy it, though.

All in all, I feel more than ready for Lexie to come home tonight.  In fact, this is going to be the longest day EVER!!!  Come on 5:00 p.m.!!!!