Saying Good-Bye

When I got up this morning, I found that Lexie's mammary wounds had bled through her doggy bed during the night.  I can't believe she even found the strength to get up, go down the front steps, and walk into the yard to pee, but she did.  She did it for me.  She fought so hard for me for so long, but she collapsed on the sidewalk before she could make it back into the house, and I knew at that moment that I wasn't going to make Lexie fight any longer. 

Justin sat with her and said his good-byes while I got ready to take her to Dr. Ellis.  Then, before I left, we held each other and cried as I thanked Justin for taking such good care of my Lou.  I told him how much she loved him.  It broke my heart to see him crying so hard for her, and for me, but it also made me realize just how lucky I and my girls are to have him in our lives. 

Unfortunately, Dr. Ellis wasn't at Animal Care Clinic today, so they sent us to Dr. Mark Ayers' office.  All of the staff and Dr. Ayers were so kind to me and Lou.  I'm glad that she was surrounded by so many kind, happy voices in her final hour.  I'm also so glad that I decided to stay and be with her while she was euthanized.  I put my forehead against hers and held her face in my hands as I thanked her for loving me and told her what a good girl she was.  She was peaceful, and I also felt at peace as I finally let her go.  I made her promise to find me again someday, though.  I have a feeling she will. 

Oh, Moomie.  I'm going to miss you so very, very much.  You'll always be my little turd, and I'll love you until my last breath.  Thank you for making me so happy for so many years. 

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.

What I Haven't Told You...

I wanted to take a moment to address something that I’ve been hearing a lot during the last month or so.  While I have greatly appreciated all the kind comments and praises that I’ve received for going to such great lengths to save Lexie’s vision, and eventually her life, I feel that if everyone knew exactly what Lexie, Jocie, Sam and I have been through together, they wouldn’t think that I was just being a good pet owner, they’d understand that there simply was no other option when it came to saving my Lou.  Therefore, for the sake of painting a more complete picture, I have decided to share an important part of our past.  (I haven’t shared this story before now because, well, it’s kind of a downer, and I also didn’t want people to think that I was just pulling out all the stops to gain sympathy, especially when I had to ask for donations a few weeks ago). 

My girls and I experienced a horrible tragedy in August of 2009, when my husband of 7 years, Chris (whom I had been with for 14 years), chose to take his own life.   He made this decision after a long struggle with alcoholism and failing physical and mental health (pancreatitis and possibly early schizophrenia, although he was never officially diagnosed).  Chris and I had always planned to have children someday, but until we felt the time was right, Jocie, Sam, and Lexie were our children. (It was actually Chris who insisted that we adopt Lexie, despite my reservations about owning three dogs at the time, because he wanted to have a least one dog he was confident would protect me whenever he was away.)  

It’s impossible for me to give a Cliff’s Notes version about everything that happened leading up to Chris’ suicide because it was (to put it very mildly) a giant, complicated, five-year-long mess.   The bottom line is that his gradual, almost unnoticeable at first, downward spiral of mental illness took a sudden plunge in the last few months before his death.  At one point, after we had eventually separated, he had uncharacteristically threatened to shoot me, shoot the dogs, and then shoot himself.  For this reason, when he showed up at my house on that warm, summer night almost three years ago, I initially struggled when he tried to push his way through the front door because my first instinct was to protect the girls.  However, when the towel he was carrying fell to the ground and revealed that he was holding a gun, I knew I just had to get away from him as quickly as possible.  To this day, I still wonder if he had actually come to the house that night with the intention of shooting me and the girls, as well as himself.  I guess I’ll never know, but I will be forever thankful that he let me go and allowed all three of our girls run out of the house before he took his own life in the living room.

Needless to say, it was an extremely traumatic experience for all of us.  Jocie became reclusive, Sam lost almost all the fur off her back, and Lexie wouldn’t let me out of her sight for the month or so that we stayed at my Dad’s afterwards.  Finally, after I was unable to find a new place to live that would allow me to keep all three dogs, I made the very difficult decision to move back into my house.  I wasn’t sure if I would be able to survive in that house, which was so full of wonderful, horrible, and now tragic memories, but the night we moved back in I knew I had made the right decision for my girls, as I hadn’t seen them so relaxed or happy in a very long time.   

Jocie, Sam, and Lexie all comforted me with their unconditional love during that very difficult grieving period, but it was Lexie who actually motivated me to keep moving forward.   It was hard for me to stay sad or depressed for too long when inevitably Lou would bring me one of her stuffed animals and try to entice me off the couch for a game of chase.  It was also hard to feel lonely when Lexie would always insist on laying her head in my lap every time I watched TV, talked on the phone, worked on my laptop, etc.  She even helped me run the household, so to speak, by making sure that I and her sisters stuck to a strict feeding and bathroom schedule (her internal clock is pretty impressive).   In fact, watching all three of my girls fall so easily back into their daily routines and carry on with their lives, thanks to Miss Lexie always cracking the proverbial whip, greatly inspired me to pick up the pieces of my own life and move on.

The bottom line is that Lexie is the one who deserves all the praise for saving me.  She helped me survive when I needed her most, and so I will never do anything less than the same for her.

Surgery #3 Was a Success, But....

The last time I received a "but" after one of Lexie's surgeries, it was, "Lexie's surgery went really well, but we did notice she has developed an infection...."  That infection, of course, turned out to be extensive and actually two different types of bacteria (staph and serratia), which caused Lexie's incision to pull open just approximately 14 hours after she was discharged from MetVet.

Dr. Kennedy called me last night around 9:30 p.m. to tell me that Lexie's surgery to repair the incision and also remove two mammary growths (not just one, as it turned out) went well, "but the anesthesiologist did make a note of some twitching that occurred during anesthesia."  I asked Dr. Kennedy if this is a reason for concern, but he didn't seem too worried about it.  He said he just wanted to mention it simply because the anesthesiologist noted it on Lexie's report, but he didn't think there was any reason to be concerned.  After all Lexie has been through, though, I wouldn't be surprised if she had a grand mal seizure a few hours after I get her home.  (Oh God, I didn't mean that!  *knock on wood!  knock on wood!*)

Anyway, Dr. Kennedy just called me again this morning to give me another update, and apparently Lexie did really well overnight.  He said that there was some swelling, but nothing like she had before.  He also said there was a little oozing from the incisions this morning, but that is to be expected.  I asked him if her eyes were going to ooze bloody fluid non-stop like they did the last time I brought her home, and he said he didn't think it would be as bad this time. 

On a side note, I asked Dr. Kennedy if they had ever received the results of Lexie's Von Willebrand's test (I noticed on her bill from her last surgery that I was charged for that test).  He said he wasn't sure if they had received the results back yet, but that he'd check.  I know that it takes a while for that test to come back, so I'm not going to be upset if they don't have the results yet.  Besides, at this point I'm kind of convinced she doesn't have Von Willebrand's because bleeding wasn't an issue in either of her last two surgeries.  I'm starting to think that Dr. Corbett's theory for why Lexie almost bled to death during her initial enucleation surgery is probably true:  She said that it's possible that all of Lexie's bleeding simply resulted from the fact that the eyes are very vascular organs with lots of veins and blood vessels that have to be surgically cut during an enucleation. 

So, technically, Lexie is allowed to come home tonight, but I told Dr. Kennedy that I would prefer to wait until Saturday to pick her up.  I reminded him that the last time I brought her home the day after her surgery, her stitches burst 11 hours later.  He said he completely understood and thought I was making a wise decision.  I know that leaving her two more nights for observation is definitely a better decision than picking her up this evening, but it's also killing me to know that she could come home tonight.  I want my Lou home with me so badly!!!!  I'm going to be strong, though, and hold off until Saturday morning to go get her, because I know it's for the best.  Well.....maybe tomorrow night.....

Background - Part Three to Present Day: The Enucleation Decision

When Dr. Ellis called me Monday afternoon, just as I was leaving to go pick up Lou from the vet, she reported that Lexie's right eye pressure was 46, which is the highest it's ever been, but surprisingly her left eye pressure was normal.  She said she spoke with Dr. Corbett, and Dr. Corbett said that there is only one medication left that we haven't tried, but it's extremely hard to find and it's very expensive.  Then, Dr. Ellis told me that, because Lexie has not responded well to ANY of her treatments, and because her eye pressures have continued to build and fluctuate, Dr. Corbett had advised enucleation, and Dr. Ellis agreed.  My heart sank.

When I arrived at the vet just a few minutes later, Dr. Ellis was waiting on me.  I could tell that she was truly sorry that we weren't able to save Lexie's eyes, but I know in my heart that we did all that we could do.  After all those trips to the vet in both Huntington and Ohio and all that medication, at no point did Lexie's eyes look like they were steadily improving.  One day they might have looked a little better than the day before, but then just as quickly one or both of her eyes would look much worse.  So, at this point, it just kind of feels like this is what's meant to be.  However, just as I was wrapping my brain around the concept of having Lexie's eyes surgically removed, Dr. Ellis said, "It's your decision whether or not you want to remove both eyes, or just the right."  


Whoa.  Wait.  What?


I have to CHOOSE whether or not Lexie has her left eye removed?!?!?!  I asked Dr. Ellis for her opinion, and she recommended that I have them both removed in one surgery.  She said with the way her eye pressures had been fluctuating, she was almost certain that Lexie's left eye would have to be removed eventually anyway.  She told me to think about it, though, and call her in the morning with my decision.  She said that Lexie's right eye was definitely causing her pain, so the sooner the surgery, the better.


I had read online somewhere that it's very important for owners of newly blinded dogs to stay upbeat because your sadness can make your dog even sadder.  So, the first thing I did when we got home from the vet was I went up to my bedroom and bawled for about an hour.  I couldn't stand the thought of my Lou never looking at me with those big, brown, sparkly eyes ever again.  Then, I started toiling over the decision to remover her left eye.  After all, the pressure in that eye had been normal, which meant it wasn't causing her pain, it looked a LOT better than her right eye, and I could tell she could still at least see shadow and light.  How could I possibly decide to remove her left eye when it looked so good and still seemed to have some function?

Regardless, I knew that the logical decision was to have both eyes removed at once since the chances are very good that her left eye would need to be removed eventually.  So, that night I made up my mind that I would schedule her for a double-enucleation on Friday (so I could be home with her over the weekend).  However, the decision didn't sit well with me all night and, in fact, I awoke at 4:30 the next morning literally in tears over it.

So, the next day I thought it over and finally decided that my heart simply would not let me live with the decision to remove her left eye for all of the reasons stated above.  If it looked as bad as her right eye and/or I knew it was causing her pain, it wouldn't even be a question, but as it was I decided I would let her keep her left eye until it became medically necessary to have it removed.  The moment I made that decision, I felt a million times better.

I continued to feel good about my decision, in fact, until yesterday.  I have been Googling all sorts of things regarding canine blindness, helping a dog adjust, enucleation photos to prepare myself for how she'll look after surgery, etc., and somehow I stumbled upon a blog, very similar to this one, written by a woman who's dog had undergone two separate enucleations.  She said that the second surgery was actually much harder on her dog because he had grown so accustomed to being able to see shadows and light out of his one good eye after his first enucleation.  Therefore, when he awoke to total darkness after his second surgery, it really freaked him out.

Reading this really made me doubt my decision to save Lou's left eye.  Was I really prolonging her quality of life, or was I just trying to avoid the inevitable for my own selfish reasons?  I fully admit that one of the main reasons I didn't want to have her left eye removed was because I wanted her to still be able to look at me with at least one eye, even if she couldn't really see me.  Again, I just couldn't stand the thought of her NEVER being able to look at me ever again.  However, I knew deep down in my heart that her left eye would have to be removed at some point.  I was even a little worried that her left eye might take a turn for the worse immediately after her right eye is removed, and she'd end up having back-to-back surgeries.

I went home from work yesterday toiling, once again, over this decision, but as soon as I got home I realized that the decision had already been made for me.  Lexie's left eye had gotten MUCH worse while I had been at work.  It is now just as cloudy as her right eye, bulging a little bit, and she was even pawing at her eye, which is a sign of pain.  I know this may sound awful, but I was actually kind of relieved to not have to struggle with this decision anymore.  Knowing my Lou is in pain takes away any other option, as far as I'm concerned.  Both of her eyes simply have to be removed.

So, now here we are.  Less than a month from the first sign of inflammation, it's the night before Lexie's scheduled enucleation surgery.  I'm still 100% certain this is the right decision, as her eyes both look really bad tonight and it doesn't even seem like she's seeing much shadow or light anymore.  At this point, I'm almost anxious for the surgery because I just don't want her to suffer anymore.  My hope is that once her eyes are removed she will be completely pain-free, and then hopefully I'll start to see her spunky little personality start to come back.  Right now, she's kind of depressed and obviously doesn't feel well, so she hasn't acted like "my Lou" in weeks.  I know it's going to take a while for her to recover from the surgery and adjust to complete blindness, but I'm fully confident in Lexie's ability to adapt.  In fact, I have a feeling this blind little Dobie is going to blow us all away with her amazing new abilities when it's all said and done.

In the meantime, I'm not gonna lie, tomorrow is probably going to be one of the toughest days of my life.  I will be dropping Lou off at the vet when they open at 8:00 a.m., then waiting on pins and needles while TRYING to work all day to hear how her surgery went.  I'm not sure if she's going to need to stay overnight, but thankfully my vet is open on Saturdays, so hopefully I can pick her up the next day at the latest.  I'm sure that I'm going to be incredibly sad and even a little bit horrified when I see her for the first time, but that won't stop me from babying the hell out of that little turd all weekend long.  In fact, I think I'll go baby her right now.