The diagnosis came as no surprise, nor did the timing. Golden retrievers are prone to cancer; some studies suggest six out of ten will develop malignancies. I’d lost little Tuppence the Wonderbitch to cancer at the age of ten. Barley came from the same genetics, and males typically live a couple years less than females. Those who have observed me grooming my dogs note that in the process I conduct a cursory physical exam of eyes, ears, nose and mouth; checking for firmness or tenderness of the belly; carefully palpating lymph nodes.
In January, right around his eighth birthday, I noticed his gums were pale, his belly firm but not hard. A day later I noticed subtle changes in his demeanor. His affect was flat, his exuberance at meal time diminished. Never one to decline a treat, Barley would cheerfully supplement his diet with anything he could get his teeth on: table scraps, rodents, vegetables right out of the garden, wild blackberries at the edge of our meadow, and unattended meals left on kitchen counters. But now, as we cuddled by the woodstove while a fierce winter storm lashed the house with sub-zero gusts, he turned away from treats. And then the polyuria/polydipsia started: drinking and peeing very often.
I made a vet appointment for the following day.
Years ago we had a phenomenal veterinarian in Steve Woodard, DVM. He had no fancy equipment in his small office, just a vintage x-ray machine and an old microscope, but his skills as a diagnostician were such that on those few times when he referred us to a specialist, his provisional diagnosis was spot on. We lost Steve, ironically, to cancer, and the entire county mourned his passing.
His practice was passed on to Emily Crawford, DVM. Had I known nothing at all about her skills, the fact that Steve chose her to care for his clients would have been enough. But she is an exceptional vet in her own right, with the bonus of a background in oncology and remarkable competence in the “Snap out of it, man! Your dog needs you to be positive!” department.
Barley’s symptoms fit no classic pattern. The pale gums came and went. Some days his belly was firm and others it was soft and supple. There were no enlarged lymph nodes that we could palpate. Heart and lungs normal. His urine was dilute but unremarkable. The only truly abnormal results were his platelet count was low, and his serum calcium was dangerously high. I was thinking cancer. Emily might have been thinking that, but she also wanted to rule out an adrenal mass.
We were sent to see Dr Amy Cordner, an internist at the Burlington Emergency Vet Service clinic in nearby Burlington. A full day of tests, an ultrasound that discovered a single enlarged lymph node deep in his abdomen (too deep to palpate), and a needle biopsy of that node gave us a diagnosis of lymphoma. The only way to determine what type of lymphoma – the aggressive T-cell variant that had taken Tadcaster from me, or the much less aggressive and more treatable B-cell variety – was to perform surgery to remove the entire node and send it out for analysis.
I simply could not do that to Barley. One of the cruelest facts of life is that we and our canine family members have such disparate life expectancies. But a dog has no notion of mortality. A dog is simply here, and loved, or not. If Barley had cancer, he would at least enjoy the time he had left with me. I would not have his last few months filled with the pain associated with abdominal surgery. So I returned to Dr Emily, had a long talk with her about my philosophy of life. Together we decided to give Barley one full round of chemo. If he tolerated it well we would treat him as if he had the B-cell variant. If his body responded we would know we were right.
Human survivors of chemotherapy will be familiar with the drugs used in the CHOP protocol: vincristine (injectable), cyclophosphamide (oral), doxorubicin (intravenous), and prednisone (oral) administered in turns, with their impact on white blood cell production monitored weekly. Just as in humans, every patient handles chemo differently. Emily charted Barley’s bloodwork to enable her to see trends that would allow her to adjust the dosage or timing as needed.
Barley went into full remission very quickly, tolerating the drugs with minimal and very short-lived side effects. Shortly before the new year we had bought a house in a much more rural, scenic part of Vermont. Between the purchase price and the cost of getting it ready to live in, we were stretched very thin. But as my wonderful dog curled up to me each night, his loving personality telling me that life was still very much a good thing, there was absolutely no doubt in my mind.
The fight is on.
15 May 2015: Barley continues to do very well. Full remission, though every little cut or incipient hot spot gives me pause. He has always had an issue with seasonal allergies, and to stay on top of that I’ve been washing his underside from crotch to ruff with a warm washcloth every night. He loves it, and the moment he hears the water running in the tub he appears at my side, standing bowlegged, waiting for his nether regions to be wiped down. The weather was perfect today, so we took a spin around town.
6 June 2015: D-Day Bloodwork came back perfectly normal as we enter the last full round of chemo. I know the drugs have adverse and cumulative effects, but they brought him back to his normal playful self when I thought I was about to lose him. We caught it early and treated it immediately, but I know once the chemo stops my mind is apt to leap to conclusions every time Barley has an off day. I know I will eventually lose him.
But not just yet!
I cherish this dog. My mornings start with the thumping sound of his tail whacking the floor and the underside of the bed the moment he hears me stretch. At first sight he rolls over and reaches out to me with his large paws, vocalizing his joy at waking up with me. We snuggle, one paw thrown over my neck and his muzzle pressed against my cheek while he makes happy grunting sounds.
Not just yet…