THE CANCER SAGA CONTINUES

New Year's Eve and New Year's Day were as depressing as Christmas. I was nervous over the different possible outcomes of the surgery; I hoped for the best but I was expecting the worst. Artie, on the other hand, was extremely angry about how this played out; the possibility of losing Annie so soon after losing Buddy was very distressing. Both of us were upset that by trying to avoid any surgery Annie now had to go through not one but two operations.

Friday, January 4, 2013, the day of the follow-up surgery arrived. Annie's appointment was for 7:30 AM. Her surgery was scheduled for morning. I received a call during the afternoon from Dr. Cherrone, the surgeon who performed the operation. She sounded very upbeat as she reported Annie went through the surgery successfully and was recovering nicely, however, we would have to wait for the biopsy results to determine if the margins were clean and whether or not we had to go forward with radiation therapy.

Both Artie and I were emotionally totaled, counting the hours until Annie could come home. 6 PM Saturday we were at VERG waiting to collect Annie, get post-op instructions and leave for what we hoped would be an uneventful evening at home. When Annie entered the exam room, we were stunned to see her acting completely normal. The only evidence of surgery was the big bandage wrapping her entire midsection. She was alert, thrilled to see us and busily exploring the room, smelling the floor and furniture and, as always, begging for attention from the Veterinary Technician and us.

Annie was on medicine and we needed to keep the bandages on for awhile until we were sure any residual bleeding or oozing from the wound stopped. Never in my wildest dreams did I expect to pick up Frankenweenie but that is exactly what Annie looked like with her long scar closed by staples! The pictures below were taken about two weeks after the surgery. A significant amount of swelling at the surgical site had already gone down and her hair was starting to grow back.

My next post will continue with our post-surgery experiences.

Annie resting prior to our daily exam of her sutures.

The second surgery incision was twice the length of the first surgery.

Close-up of staples; you can see swelling especially at both ends of the incision.

Another close-up of Annie's surgery.

ANNIE'S CANCER SURGERY

Quite a while ago I promised to write about Annie's surgery once I could bring myself to do so. Now is the time.

As anyone following this blog will know, Annie had a lump at the bottom of her rib-cage for more than a year. Both myself and Artie as well as Annie's doctors were monitoring it. The lump felt like a fatty tumor. At the time of Buddy's death, Artie wanted to have it removed; I did not want to put her through surgery if it wasn't necessary because of her age as well as the dangers associated with surgery and anesthesia. We decided to continue to monitor the lump.

Around Thanksgiving we noticed the lump was bigger. Not by much but now we were concerned with 'quality-of-life' issues - would it be uncomfortable for her to lie on her side? If we didn't remove it now and it became bigger wouldn't surgery be riskier as she aged?

Annie went for an office visit December 13th. We discussed our concerns with the doctor and a sample was taken. When the cytology report came in December 15th, the findings were as follows:

"No significant inflammatory response was evident. The spindle cells displayed minimal atypia. Findings may reflect a benign fibrosing cystic structure, cystic spindle cell tumor (fibroma or low grade malignant potential sarcoma), or other underlying nonexfoliating fibrosing cystic structure."

At that point the both of us AND the doctor wanted it removed. Surgery was performed December 20th; Annie came home the same day. She was still somewhat under the effects of the anesthesia, on Rimadyl, not interested in food or water and did nothing but sleep. It took a few days for Annie to return to her usual self - a sure sign that my girl is older now.

Christmas was a somber affair as we worried about the biopsy results. The results of the biopsy came December 26th and the lump definitely was cancer. The report characterized it as a slow-moving soft tissue sarcoma. The surgery did not produce clear margins; Annie needed to have additional surgery. If the second surgery did not produce clean margins, she would need radiation therapy. We were referred to Dr. Cohen at VERG (Veterinary Emergency Referral Group) and an appointment was made for the next day.

Early the next day, Artie and I took Annie for her consult with the oncologist. Dr. Cohen was wonderful and Annie fell in love with her. After the exam, Annie was taken for a series of x-rays while we waited in the examining room.

Dr. Cohen returned with the x-rays and reviewed them with us. Annie had several points in her favor.

1. Her behavior was normal which Dr. Cohen assured us was a good sign.
2. There were no visible tumors on any of the x-rays - a good indicator that the tumor most likely wasn't metastatic.
3. Radiation would only be needed if the second surgery did not produce clean margins.
4. Annie had a good chance of a 100% recovery if the second surgery produced clean margins.

We discussed radiation therapy which would be done over a period of eighteen days if needed. My mind was reeling from the logistics.  There were 3 places Annie could go to, the Animal Medical Center in NYC, a facility upstate or a facility in New Jersey. She would go on an outpatient basis which meant going in and coming home daily or she could stay for 5 days coming home for the weekends. Dr. Cohen suggested not thinking about next steps until we had the post-surgery results. The follow-up surgery was scheduled for January 5th and we all went home to wonder what 2013 had in store for Annie health-wise.

I will pick up this narrative in a second post along with post-surgery photos.

NEVER A DULL MOMENT

Did I ever think for one minute Orphee's surgery would be the only issue to deal with Monday? If I did then I was to be sorely mistaken.

It was an extremely busy day. We had to travel to the clinic to drop Orphee off and then again to pick him up. Breakfast out at a local diner then some grocery shopping just so the trip would accomplish more than delivering Orphee for his surgery then home. We did some housework in the intervening hours then made the trip again to pick up our patient.

We monitored him for the rest of the evening, fed Annie, did chores and headed off to bed at 2 AM, a very long day indeed. Annie would not settle down so I let her out and to my horror she passed bloody urine. She began to whimper and seemed very tense and uncomfortable. By 3 AM we were at the 24 hour Emergency Veterinary Service.

Thankfully, we were the only emergency - no other pets or pet owners just an empty waiting room. We were led to an examining room where a Vet Tech did a workup and we awaited the doctor. By now Annie was really crying and begging to be petted. I knew it was serious because Annie LOVES going to the doctor. It is an exciting adventure for her filled with new sights, new sounds, new smells and above all new animals to see and new people to make friends with.

The doctor examined her, asked questions and I could tell that her recent cancer surgery and the possibility of it spreading were on his mind although he didn't voice it. By 4 AM we were back home with antibiotics and painkillers, instructions on how to administer the meds, what to watch for and a reminder to take her to her doctor one week after finishing the medicine, sooner if her symptoms worsened.

I opened the door to the inner hall to find a note informing us Orphee picked our departure as the time to move into my apartment.  There in the Living Room was Artie asleep in the recliner with Orphee in his lap. Annie was only interested in going back out; totally ignoring him as she headed for the back door.

After wrapping her pills in boiled chicken and managing to get some of her medicine in her, I put her to bed then lay next to her. Covering her up and throwing a heavy bathrobe over myself, we fell asleep for a few hours. Orphee headed for the front stairs when Artie left for work at 6:30 AM. I left with him, heading for a local Mom & Pop store to purchase a jar of peanut butter - a surefire fixer-upper to get Annie to take her pills without a battle.

The peanut butter did the trick and with the remainder of her pills ingested both Annie and I went back to sleep to try to recoup from the evening's emergency.

ORPHEE AND SURGERY

The big day finally arrived Monday and Orphee was off on his second adventure this time to be neutered.  We dropped him off by 8:30 AM. After going through what would be done and what we had by way of a medical history, we were instructed to return for him between 5 and 6 PM.

Artie and I used the opportunity to vacuum and wash the hallway stairs and floor. We emptied and disinfected his litter box, filling it with fresh litter. Then we settled in to wait. I discovered I really missed him being around even though he only hangs out in the outer hallway. Artie felt the same. Annie kept looking for him as well which was funny because he won't let her get near him.

We picked him up, received instructions for his care, found out he did fine and were told repeatedly what a handsome guy he is. They also couldn't get over how big he is. At last weigh-in Orphee was 14 lbs. Needless to say, Orphee was a bit groggy from the anesthesia. When we arrived home we put the case on our couch to let Annie and Orphee get to see each other eyeball to eyeball and to smell each other. That went well.

Orphee surprised us by calling us after he used his litter box (apparently he decided it needed to be cleaned). He also sat upright outside the apartment door looking inside. Artie brought him in and walked him through each room allowing him to get a good look at 'the lay of the land', hoping he will become more at ease with his new surroundings. Then we placed him on the floor.

He surprised us by slowly walking to the apartment hallway and hanging out there for awhile before deciding to head back to the outer hall and his stairs. He also surprised me by crying very loudly for food; something he never did before.

By the end of the evening he was fully alert but surprisingly exhibiting more of what is probably his real personality. Orphee is getting comfortable with us and coming into his own. We're thrilled.