Yuki’s struggle against cancer has received a significant blow this week, and the prognosis is not good.
First to recap how we got here, it was October, 2017, when we took Yuki to the Vet for a skin problem and Yuki left the Vet diagnosed with stage 4 Lymphoma. We got Yuki to the Oncologist soon after and started his 20-week chemotherapy treatment. This treatment was a success and his cancer was in remission by February, 2018. By July, however, his skin problems had returned. We had determined previously that these skin problems happens because the cancer weakens his immune system, and sure enough, the return of the skin lesions announced the return of his Lymphoma. At that point Yuki began his second round of chemotherapy. This time, as was expected, the cancer was more resistant, but the Oncologist has changed up the protocol and the Lymphoma was receding. Hope that we might see 2019 with Yuki still alive grew stronger as the weeks progressed, but that hope was quickly dashed this week.
A little over a week ago a large bump formed on Yuki’s left front wrist, almost overnight. We hadn’t noticed it and the Oncologist was surprised by it during Yuki’s weekly visit and exam. We discussed with the Oncologist what it could possibly be and decided to wait a week to exam it, hoping that a bug bite, or some other irritation had created it and the bump would subside. A week later it was still there, though possibly a little smaller. The Oncologist took an X-Ray to see what we were dealing with and everyone’s worst fears were realized. Yuki is determined to have “a proliferative bone tumor that resembles osteosarcoma or chondrosarcoma.” Yuki has a new cancer in combination with his current Lymphoma, and this one he won’t be surviving.
As explained to us by the Oncologist, bone cancer in Dogs is pretty much terminal. The way it is traditionally fought is, in this case, via the removal of the compromised limb. In other words, they would have to amputate Yuki’s front left leg. Then this becomes a discussion about quality of life for Yuki. With his bad rear hips, he relies heavily on his front legs to get around. His rear legs doing not much more than acting as a rudder. He has the enlarged chest and front legs of a dog with wasting hips and rear legs. If we take away one of those front legs Yuki will probably be practically immobilized. Yes, he could hop from his bed to the food, and possibly outside, but he won’t be able to climb (or more importantly descend) stairs, so he won’t be able to join us at bedtime, which could be perceived as a punishment in his mind.
Yuki is happy and energetic in spite of all his ills, or possibly because of them (he’s always had some problem, including a lifetime of hip pain, so to him, that’s just life) but I think removing a leg and limiting his ambulatory abilities definitely crosses the line of keeping him alive for our sakes and not his. This, however, isn’t the worst of it.
The worst part is understanding one of the main reasons they do the amputation in the first place. The bone cancer weakens the bone as it grows and eventually, and especially in Yuki’s case because of the location and his dependence on his front legs, that bone will break. And once that bone is broken, because of the cancer infestation, there’s no repairing it. At that point you either remove the limb or say “goodbye”.
Our decision, with all this information, is that we’ll not remove his front leg and the Oncologist will do some injections of zoledronate into the leg to try and maintain the bone’s strength as long as possible. The Oncologist has also recommended palliative IMRT radiation therapy to try to reduce the size of the tumor as it will eventually become extremely painful if, or as, it grows. Yuki hasn’t shown any real irritation by this mass on his wrist outside of favoring his leg one day after running around the back yard. He still puts weight on it and goes up and down the stairs. Perhaps the radiation treatment will aid in making it more bearable, but he’s already on so many pain medications for his hips it might not be so surprising he’s getting by unless he really overuses his front leg walking or running too much.
All of this is to say that Yuki is losing his cancer battle. We probably won’t have him with us much longer unless the Oncologist pulls out a miracle chemotherapy treatment that attacks two cancers at once, but even then it’s really just a matter of time before Yuki’s leg breaks and a decision is forced.
We’ve had Yuki for 12 more months than we should have already. He had a month to live a year ago, and now we’re back to him having a month to live again. The extra year we got with him now seems ridiculously short.