The Dog Cancer Survival Guide (77 page)

By answering the following questions, you will be facing your dog’s cancer head on and recording your thoughts in black and white. The truth of what you are up against may become clearer and more “real” to you than it has up to this point. We can’t predict what emotions this might trigger; the breathing exercises from
Chapter 2
might come in handy.

Although this analysis is straightforward, sometimes guardians feel stumped. If you get stuck or you can’t answer a question, it may be because you’re feeling overwhelmed. It will help to focus exclusively on your dog for a moment. Be with him and “tune in” to whatever he’s experiencing at that time. Once you are tuned in, look at the question again and listen carefully for the answer. Listening from this space of connectedness may help you to relax enough to hear your answer come welling up from deep inside. If you still feel stumped, go to the next question and return to the tough one later. You can always use the exercises in
chapter 2
, if needed.

Once you have finished answering these questions, you will have a wide-angle view of your dog’s cancer and will be ready to consider possible treatments.

First, let’s get an overview of your dog’s cancer. Write down your dog’s diagnosis, based on what you know from tests that have been run so far. What type of cancer does your dog have and how advanced is it? Has it metastasized? Where?

Now write about your dog’s possible prognosis. Does this cancer tend to be aggressive? Is it eligible for curative surgery? Palliative surgery? Chemotherapy or radiation? How long does your vet or oncologist expect your dog to live, with the treatments they recommend? How long without the treatments?

Take some time to review your vet’s and/or oncologist’s reports (if you don’t have copies, you can get them, see
page 256
). What does Dr. Ettinger say about your dog’s cancer in her section of the book? Make notes about what you learn. You may not have the answers to all of these questions; write down what you know so far, and make a list of questions you need to get answered.

My Best advice:
It is worth repeating that the prognosis is neither a promise nor a guarantee. Instead, it’s a best guess at how long your dog has, based on what conventional veterinary medicine knows at this time. Some guardians make the mistake of thinking it predicts the day of their dog’s demise, as if it’s an execution day. Many vets think of it this way, too. Cancer is not an automatic death sentence, and thinking of it that way is not only unscientific, but also distressing and unhelpful.

Cancer is not an automatic death sentence, and thinking of it that way is not only unscientific, but also distressing and unhelpful
.

No one really knows when your dog will pass from this world, or what the cause of death will be. I suggest thinking of the time given for a prognosis as a mile marker on a highway – it tells you where you are, in relation to the expectations of the conventional medical establishment. It is a useful way to orient you, but it is not definitive.

Another piece of data that can help establish a wide-angle view of your dog’s situation is the average life expectancy for her breed or weight. Based on the charts in
Chapter 19
, how long is your dog expected to live on average? How old is she now? How much more time does she have, based on these conventional expectations – or has she already lived longer than expected?

This calculation can feel coldhearted, but it is important to know where your dog is, in relation to the average length of life for her breed and/or weight. Like the prognosis date, this can help you to orient yourself when considering your options.

My Best Advice
: Many guardians get very upset after they try a recommended treatment and their dogs do not live “long enough,” as a result. This question is designed to help you set your own expectations for what constitutes “a long time” for your own dog. Particularly for dogs with cancer, “a long time” for a dog may not feel like a long time for us guardians.

For example, if a dog is expected to live for ten years and a cancer that is left untreated will probably shorten her life, that is a tragedy. On the other hand, if a particular treatment could extend her life by a full year, that is
ten percent of her lifespan
. From a veterinary perspective, this increase in longevity is a big success, because we are calculating time in the dog (not human) years
for that dog.

To put this in a more human context, consider a hypothetical human case. Let’s say that Dan is a gentleman who is expected to live to 80 years based on his family history and his overall state of good health. Unfortunately, Dan is diagnosed with cancer at age 70. The prognosis for survival time is one year without treatment and eight years with treatment. In this hypothetical case, the treatment would extend life to nearly the expected lifespan – and provide a gained life expectancy of nearly ten per cent. Is that a long time?

It depends upon your perspective, of course. If Dan spends those years in relative comfort and with few side effects or other health conditions, it could feel short. On the other hand, if those years are spent weak, sick and bed-ridden, they might feel long. We cannot possibly generalize about how long is too long for other humans. We can’t generalize for dogs, either. This is an exquisitely individual matter, and it’s important to know where you stand. For some guardians an extra three months is a precious miracle. For others it is the blink of an eye.

Make a few notes for yourself: write down the expected lifespan for your dog, your dog’s current age, and the difference between the two. Also write down how many months your dog has left, according to the prognosis (with and without treatment). Two different guardians, looking at this same set of numbers, may have radically different opinions. What’s important, of course, is
your
feeling about
your
dog.

“I did not do radiation or chemo. I did not want to put Jazzie through that. If his cancer were a different kind, maybe I would have. [My best advice is] don’t give up on your dog. Read about what kind of dog care giver you are before you make decisions. I wanted to cure Jazzie, but I was unwilling to do things that may have made him feel bad. I was “the best dog caregiver” I could be within my finances and time. [Taking care of you first] is important, because one must be strong and know how to proceed emotionally.”

- Jo Anne Kikel, Denver, Colorado

Longevity is not our only concern; life quality is also important. List your dog’s specific joys of life. Have they decreased in number because of the cancer? Will certain treatment side effects, other illnesses or conditions affect them? If there is life quality loss, is it permanent or temporary? Can life quality be boosted?

These are important questions, because the answers can have a big impact on the type of treatments you choose. For example, managing side effects is imperative when overall life quality is already suffering. Sometimes other health issues or health conditions negatively impact life quality. For example, some dogs get cancer at an advanced age, after they have lost some vision or hearing. In these cases, when quality of life may already be lowered, you could be unable to do much about it.

If you read the earlier “joys of life” discussion with a lump in your throat because you fear that your dog’s quality of life is low, I recommend you make a list of the joys you would like to work on and include them in your treatment plan. Also, make a list of any side effects your dog is currently experiencing which will need to be managed.

Life quality certainly goes down when there is unmanaged pain, so take a moment to assess your dog’s current pain level. Pain management is an important but sometimes overlooked part of cancer treatment. Managing it effectively can increase overall life quality, which, as we’ve discussed, can help your dog get an edge on cancer. Based on what you learned in
Chapter 17
, make a point of discussing any signs of pain with your vet or oncologist, as soon as possible.

While every guardian loves her dog, not everyone approaches cancer and cancer treatments in the same way. There is no one right way except the way that is best for you. Therefore, one of your most important tasks is to establish your overarching priorities for your dog’s cancer. To help you, I’ve created a device that can allow you to see yourself from a wide-angle perspective: “guardian typing.”

Most guardians seem to fit into one of three types. As you read through the three descriptions, see which one is closest to your own personality and point of view. This insight will help you to establish your own priorities and make decisions much easier.

Are you . . .

Type A:
“I will do everything I can to stop the cancer. Quality of life is important, and my main goal is to keep my dog alive for as long as possible, so he has every chance to beat the cancer. I understand that side effects can occur, as a result of treatment and I’m willing to deal with them when they arise. The risk is worth it, because the ultimate payoff is remission and/or more time with my dog.”