Ugh, friends.
I write today with really sad news about Beatrix.
She has late-stage lymphoma and has weeks or maybe months left to live.
Just writing that made me cry, and I have been crying all weekend.
She was perfectly healthy at her check up five months ago and weighed 38 pounds, the weight she has been within 2 pounds of her entire adult life.
2 years ago, she was up to 40 pounds and having some shallow breathing/overheating problems on longer walks. At that time, the vet told us she needed to basically stop walking any distance and could take dog-directed strolls if the weather was nice. I tell you that because she has been extremely sedentary for the last 2 years. She has always been a lazy, sleepy dog, even as a puppy, so we didn’t really notice that she’s been more tired.
At her check up 5 months ago, the vet noted that her teeth were looking kind of rough, so we switched her from the dog food she has been eating her entire life (Blue Buffalo chicken and brown rice) to the senior version of that same food. She seemed to not like that food very much, and she started eating with less gusto. She was still eating, though, still stealing Minnie’s food, still gobbling food under the table at dinner, etc.
Beatrix has always had a hair trigger gag reflex and vomits more than any of us would like. We noticed an uptick in the frequency of her puking in the last few weeks, but we attributed it to the food and bought the regular version instead of the senior version at the grocery store last week, especially after we noticed that she looked a little thinner (which made sense because she was eating less).
Lately, we both noticed her standing stock still and staring into the middle distance with her shoulders kind of hunched— something we both thought was weird. We wondered if maybe something was hurting her, but she wasn’t acting strangely. A few times at night, Harry had to wake her up to taker her out before we all went to bed, and twice recently, I have noticed that the back door is still locked around lunch time, meaning she hadn’t gotten up to go outside yet. But all of these things could be attributed to her age and the general mellowing of an already super mellow dog.
On Thursday, though, she experienced a rectal prolapse while straining to go to the bathroom. Not only was this gross and uncomfortable, it was unexpected since her bowel movements have been unremarkable (but here I am, remarking on them). Ben was at work, and I was working from home with the kids home on spring break, so Harry took her to the vet to find out what was up. He called me just as I was wrapping up the lunch hour and tucking Minnie into bed and asked me to come to the vet, too.
When I got there, the doctor told us that while the rectal prolapse was easy to fix (yuck yuck yuck), he was worried about what might be causing it, and he noticed that the lymph node on the left side of her jaw was larger than a golf ball. He said he suspected that she had lymphoma and that it was really advanced, affecting nodes in her chest and stomach. He noted that she has lost EIGHT POUNDS in the last 5 months, 20% of her body weight!! He said nothing felt abnormal in her rectal exam, so he suspected that enlarged lymph nodes in her stomach were making her feel like she needed to poop when she didn’t. He recommended a fine needle aspirate the following morning to screen for cancer and said we would go from there in terms of staging/oncology/treatment plan, etc.
We took her home, feeling really shell-shocked, and as soon as she got out of Harry’s car, she tried to poop and had another rectal prolapse. Gah. We took her back to the vet, where he SHOWED HARRY HOW TO PUT HER RECTUM BACK INSIDE HER BODY (and, listen, it involves honey) and gave her tranquilizers and pain pills, hoping to get her to relax and allow her stomach to stop cramping, etc. He warned us that rectal prolapse might happen again and told us the only real alternative to helping her retract it (so gross you guys) was a surgery to suture it shut, which would mean she would also need to be on heavy duty stool softeners— something the vet called “a real housekeeping issue” LOL LOL LOL.
The med combo worked like a charm, and she slept for like 14 hours, arriving for her FNA suuuuuuper relaxed.
Things moved pretty quickly from there. Her doctor kept some cells to look at at the office, but he sent the majority of the sample to pathology to review. He said he’d call us if he saw anything but that we’d likely have to wait for pathology, which could take 7-10 days. THE VERY NEXT DAY the vet called to say he strongly suspected lymphoma after viewing her slides, and, less than a half an hour later, the pathology report came in. Lymphoma. Definitely.
This is a really fast-moving cancer in dogs, but there are some treatment options, depending on things like dog’s age and cancer progression.
After the FNA, we could do blood work and x-ray/ultrasound to stage the cancer, but our vet advised us to think about just treating her with prednisone. It is true that chemotherapy can help dogs live longer and more comfortably with lymphoma, but Beatrix’s cancer appears to be really advanced— it is likely already in her stomach, and it might already be in her lungs (she has a pretty bad cough and some sleep apnea that’s worse than usual). He said if she were his dog, he would not get an oncology consult, although he said if she were 2 or 3 years old, this might change his mind. She’ll be 9 next month, though, and prednisone can give her some good days, weeks, maybe even months.
She responded to the steroid within an hour of her first dose yesterday, which the vet said he hoped she’d do. She is hungry again and peppy. She barks at TV animals and dogs walking by. She wants to go for walks. She is able to take normal poops because her stomach feels less full. All good things.
This is, apparently, the heartbreak of prednisone. Docs do not recommend chemo after prednisone because it can mess up identifying the type of lymphoma (t-cell or b-cell as I understand it) that dictates the type of chemo that’s most effective, can mask symptoms of chemo that are undesirable and would necessitate a change in meds and can really hurt the dog if left unchecked, and can just generally interfere with the effectiveness of chemo. So, you can either, our vet said, do chemo or start steroids. The heartbreak comes in when your dog responds super well to prednisone and then you think oh! Maybe she’s not actually that sick and we should try chemo. But then you really can’t.
Anyway.
Beatrix does not have much time left, and we are so sad about it.
She has been our dog of a lifetime since the first day we met her, and it’s terrible to think of life without her.
Her doctor said we would know when the prednisone has stopped working, and Beatrix is too sick to continue, and I am dreading the day. Harry wants a paw-print keepsake, so I am going to work on getting molds taken this week, and we have been advised to spend time with her, love her, pet her, etc.
It’s really fun to have old Beatrix back, but it’s also such a painful reminder of what we’re going to miss.
