Sunday, January 15, 2012

One Tough Cookie

It's been a hard week.

I took this photo of Butch on Thursday, thinking it might be his last one. I am overjoyed to tell you it won't be.



The tumors on Butch's gums that I wrote about here and here continued to grow, and about 10 days ago they began to bleed. A lot. The vet had told me Butch might chew off the tumors if they grew long enough to catch between his teeth, but I had expected that to be a one-time event. I did not expect the bleeding to be a continual occurrence.

I was laundering his bedding (and mine that he touched and imprinted with his muzzle) once or twice a day, continually cleaning blood droplets and saucer-sized bloody drool stains from the carpet (hats off to Stainmaster® for performing as advertised), and washing Butch himself several times daily because he frequently wiped his mouth on his forelegs. Because of his blindness, Butch navigates through the house by touching his muzzle against familiar landmarks, such as walls and furniture.  With his bleeding mouth, he had become a walking ink stamp.

The only good news during that time was that those tumors must have contained no nerves, because Butch appeared to be feeling fine. He was enthusiastic about meals and snacks (his that he ate and mine that he begged for) and went about his business--as much business as a nearly 14-year-old dog can manage--in good spirits.

In fact, he seemed to be feeling well enough that I thought he wouldn't fall apart during a short car ride, so on Thursday I enlisted Kim's help in getting him in the car so the vet could take a firsthand look at what was going on with his mouth. She found more than we had expected. In addition to the tumors on his gums, there was a large, black mass on the roof of his mouth. The vet suspected melanoma.

We discussed options.

Doing nothing was not an option because Butch's continual bleeding was weighing more heavily on me than I like to admit. I've cleaned up my share of urine, feces, and vomit in the years I've owned dogs, and even some blood on more than one occasion, but this constant dripping from a roving source was beginning to feel like Chinese water torture. As much as I love Butch, I was starting to find the situation intolerable. I'm being as honest as I can here, even though I'm ashamed of those feelings and believe that Butch deserves better than that from me.

A second option was surgery to remove as much of the tumors as possible and cauterize the remaining blood vessels to stem the bleeding. I didn't think Butch was a good candidate for surgery. He's so old now, and he has a history of problems with anesthesia. Would it be fair to him to put him through the pain of another surgery this close to the end of his natural life span?

That brings us to the third option: euthanasia. A number of people told me after Butch's eye-removal surgery in 2005 that it would have been kinder to "put him to sleep," but he's had six and a half pretty good years since then, so I've never regretted that choice. At the age he is now, it's a different story, and I gave it serious consideration. My daughter Kelli summed up my ambivalence about this option when she said I was struggling with this decision because I wanted to be sure I was doing it for the right reasons and not as a matter of convenience. That was exactly it. And the truth was that all that bleeding was bothering me; Butch didn't seem to be the least bit concerned about it.

The vet assured me that the surgery would be fast and easy. It would quell most, if not all, of the bleeding. I asked about cost, and she quoted a price that was exceptionally fair and reasonable. She couldn't, of course, guarantee that Butch would survive the surgery, but she laid out her plan to give him the best chance possible.

The next day, Friday, we gave him that chance. I dropped him off tearfully, knowing the odds were against him.

The vet called after the surgery to tell me that Butch was awake, sitting up, and was trying, not successfully yet, to wag his tail. They had removed the epulis (tumors on his gums), which had also involved removing two teeth. That was the good news. The bad news, she told me, was that the mass in his palate was melanoma, and they couldn't get it all. She said the melanoma was quite invasive and there is a danger that it will grow into his sinus cavities. "That," she said, "will be it." She estimated that Butch might live as long as three to six months, though his time could be shorter than that. She said to give him a week to recover from the surgery; after that, we should have a better idea of the quality of life he'll have for the remainder of his days. If Butch does well, there are inexpensive medications that have been shown to slow the growth of melanoma, and they should also keep Butch comfortable. On the other hand, if Butch seems to be suffering at the end of the week, we can stop it then. She said they'd keep Butch under observation for a few more hours, then I could pick him up and bring him home.

I couldn't believe how good Butch looked. He seemed strong and tugged at his leash, ready to get out of there.  He came home without much fanfare except for enthusiastic greetings and all-over sniffs from Levi, Lucy, and Oliver, then made his way to the backdoor to go outside and relieve himself. By the time he came back in the house, he had reoriented himself, knew exactly where he was (well, as exactly as he ever knows), and began nosing around in the kitchen. It was suppertime by then, and he was obviously hungry.

Butch's first few post-surgery meals were limited to chicken broth and small amounts of rice. He ate every bite and was clearly unhappy about the meager quantity, so as soon as we knew for sure that one meal had settled nicely in his stomach, we fed him again. He cried a little that first night, but I was never sure whether he cried from pain or from hunger. His mouth bled a little that first night, too, but not nearly as much as it did before. I was encouraged.

By yesterday Butch showed no signs of pain and could eat a full quota of his new regular diet. He will never again in his lifetime be able to eat anything of a harder consistency than oatmeal. The tumor in his palate is fragile, and any slight pressure on it will cause it to bleed. That means the spoon-feeding has to stop, because the hard metal edges of the spoon can cause damage. Fortunately, Butch has been hungry enough that he hasn't hesitated to push his muzzle into the bowl and gobble for all he's worth.

Butch is what he can never have again: one tough cookie.

Today he is eating well, sleeping well, showing affection, and asking to go outside when he needs to. When he comes back in the house, he waits patiently for a treat, and he doesn't seem to mind that the treat is soupy or soggy. The bleeding hasn't yet stopped entirely (a certain amount is to be expected after oral surgery), but it has diminished to manageable, non-repulsive proportions. A short time ago, as he slept, I pulled out a tube of braunschweiger (liver sausage), which is what I'm using as both a disguise and a soft coating for his pills. As soon as I opened the wrapper, I heard his toenails hit the floor, and in seconds he was standing beside me, sniffing expectantly. If he's doing this well two days post-surgery, I think there are more good days than bad ones in his future.

As my daughter Kim pointed out to me, the prognosis of a three-to-six-month life expectancy for a dog Butch's age, especially if those months are likely to be comfortable ones, is not too bad.

16 comments:

  1. Bless his doggie heart. One of the best things about this is that Butch has no idea and therefore is happily living each day just being....Butch. What a lucky pooch to have found such a loving and caring owner. May each day he has left be happy and without pain for your sake as much as his. Big hugs.

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  2. Thanks, Val. I'm feeling pretty lucky myself right about now.

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  3. What a lovely post!! You go, Butch!!

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  4. I love your honesty. I think every pet owners wish, is that they would lay down and go to sleep, without us having to do it for them. Just an idea, I did this for my last pet friend that was beyond help. I knew the time had come. My vet gave me sedation to take home, I administered it, and she slowly fell into a deep sleep in my arms, and my husband and I took her in for the final medication. I think and it relieved the stress of traveling in the car. For right now though, I am glad for the reprieve, for both of you! I think you're doing the best you can do. I'll be thinking of all of you. sandy xoxoxo

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  5. Rottrover, thank you.

    Sandy, this could be the perfect solution when the time comes. Thanks for the suggestion. I hated to think that Butch's last moments would be ones he finds frightening, so I will ask his vets if they'll do this for us.

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  6. Butch has amazed me as long as I've been reading your blog, and he continues to amaze me. He's an inspiration for all of us. I'm so glad he seems happier.

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  7. Janet, if Butch were a watchdog, he'd be a Timex. He takes a lickin' and keeps on tickin'.

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  8. I'm a huge Butch fan! He is amazing, charming and funny! I'm so sad at the prognosis but relieved he came through the surgery. I do believe that if any dog can prove a vet wrong, it would be Butch!

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  9. Oh Linda, my heart goes out to you and Butch. My only comment to you is that when the time comes for you to let him go, you will know. He will tell you and the decision will be mutual. Enjoy your time together -- he's quite a guy!

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  10. Hey Butch!

    Bow wow...glad to hear you are feeling better these days...some days are better and some not so good - I understand. My mom said to tell you she would like to come see you soon if that is OK and you are up to having visitors - your mom and mine are friends so it might be fun to have a get together - I hear your brother Levi is taking good care of you as well.

    Love to you,

    Ms. Chili Dog Arnett,CockaPoo
    Personal Companion to Leah Arnett

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  11. Just a note to say I'm thinking of you and Butch. I hope the days ahead are full of joy and comfort for everyone involved, the ones that love you and the ones that love Butch. I've got my fingers crossed and will write to you soon!
    Laura

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  12. Linda! I had no idea until I saw your FB post. It's been a crazy week and I hadn't gotten to your site lately. I'm so glad Butch is responding well to surgery. You are such a wonderful Mom to him. I too am heartened by his doctor's prognosis. He's such a sweet boy. I enjoy seeing his photo whenever I go into my home office. It never fails to make me smile. Sending hugs and strength to you and soft pats and but scratches to Butch.

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  13. Holly, this time last year I wouldn't have bet a plugged nickel that Butch would still be alive today, and that was before the melanoma diagnosis. Somewhere along the way, though, he got a second wind that seems to have perked him up mentally and physically. Whatever the source of that boost was, I hope it continues to sustain him in his present happy state of mind.

    Annette, I know you're right, and I plan to spend the rest of his days letting him know how special I think he is.

    Leah and Chili Dog, Levi and I would love to see you, and Butch would love to sniff you. All of us would enjoy your company.

    Laura, thanks. I know you've lived with greater fears than these of mine. You're my role model when it comes to being strong.

    Alison, it makes me smile, too, when I think about your having a photo of Butch in your office. I love that he has that effect on people.

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  14. Linda I am thinking of you and my buddy Butch. Just before Christmas my hubby Bob had to say goodbye to our faithful Lab of 20 years-yes, you read right - 20 years. We miss him so much but talk about all the fun and amazing times we had with him. I hope to be able to connect with you next week. I will be in Houston this weekend - puck a day next week for us to get in a visit.

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  15. Oh, Leah, I'm SO sorry. I don't think I've ever heard of a large-breed dog living that long; you must have taken really good care of him. We'll have a lot to talk about when we get together next week. Tuesday maybe?

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  16. Hey Linda...back in town - wanna do dinner soon? How is my man doing?

    Leah

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