The Dilemma of Maggie

Maggie and Chloe have adapted quickly to a Cape Cod existence. Chloe, with her unerring instinct for comfort, quickly found the softest cushions, the plushest throw rugs, and the most luxurious pieces of furniture. Maggie discovered the best windows from which to watch the world at large. And both dogs figured out the prime spots in the kitchen for retrieving dropped bits of food.

On Sunday morning we walked to a bakery on Main Street, where we got muffins (dry, indifferent) and then hiked over to the pier. Unfortunately, the fishmonger at that location doesn't open yet for a few days, but we took the dogs out onto the beach that runs beneath the pier. They cavorted in the sand, gleefully running into the water but stopping short of outright swimming.

After an hour, we headed back, worried about Maggie. She tires easily and her bladder problem has not resolved. Some days she squats almost compulsively, and today seemed especially bad. Inside she wears a diaper; outside she relieves herself every block or so. It's difficult to watch and even more difficult to know what to do. Our oncologist professes never to have encountered ongoing urinary tract problems, claiming that in other dogs the symptoms abate after a week or two. An ultrasound scan showed thickening of Maggie's bladder, but tests revealed no infection, nor have antibiotics made an iota of difference.  I fear that Cytoxan has damaged her bladder or urethra permanently.

Rod wavers between putting Maggie down when we return to Annapolis and letting her finish out what's left of her life. We've stopped chemotherapy, and unless her condition improves, we will not resume. Since Maggie didn't have the full course of treatment, I'm assuming the lymphoma will return before too long. I too vacillate between euthanasia and life, and I am increasingly aware of burnout. The interrupted sleep; the endless medications; the frequent trips outside have exacted a toll. And Maggie has never been an easy dog, even under better circumstances than these. Stubborn to the point of mulishness, she resisted our various attempts at training. Her first year with us, we trudged dutifully from one expert to another. The third (and most expensive) trainer, a specialist in Portuguese Water Dogs, pronounced Maggie one of the most difficult dogs she had ever encountered, ranking her third out of a hundred, a number that gave us both pause. Rod, though, loved this wayward creature, and I didn't have the heart to put my foot down.  And so she stayed, assured of a loving home to the very end.

As Maggie matured, she either became more tractable or we simply yielded to her obstreperous (but essentially sweet) nature--I'm not sure which.  If she were a more accommodating dog, her illness might be less trying. Selfishly, I sometimes think of putting her down when it just seems too damn much, between the exasperating behavior and the grueling regimen. When I'm in a nobler frame of mind, I worry that we're sustaining her suffering. Most horrible is listening to Maggie groan when she empties her bladder, but these moments are thankfully infrequent. Whenever Rod and I discuss euthanasia, she invariably rebounds for several days, swaggering around the house, blithely indifferent to our commands, and then I'm relieved to see a return to her customary truculence.

Thus our dilemma.

Another Maggie Update

First, the good news: it appears that Maggie's cancer is in remission.  Now the not so good news: she's still suffering side effects from the Cytoxan administered three weeks ago.  It's much improved, but problems with incontinence persist, making us worry that permanent damage was done to her bladder or urethra.  The oncologist assures us that eventually the symptoms will subside, but we remain anxious.

This morning Maggie cavorted outside with Chloe, running after tennis balls, barking indignantly at squirrels, and, in general, having a grand time.  It was wonderful to see her with that much energy, something we never thought we would witness again.  We didn't think she would be strong enough to go sailing with us, but after this morning, we're starting to reconsider.  I'm not sure she could manage tough sailing in high winds, but I think she will do fine with moderate winds and a partially reefed mainsail.  We'll find out next Saturday, when we do our first "shake down" sail of the season.

Maggie Update

The last ten days with Maggie have been gruesome. She had a terrible reaction to Cytoxan, a derivative of mustard gas. As one might expect from such a potent chemical, the side effects can be considerable. Typically Cytoxan induces cystitis-like symptoms, and in Maggie, these were especially egregious, resulting in incontinency and bloody urine.

Several times we thought about putting her down. I was especially distraught at her suffering, something I never wanted for this stoic creature who had already undergone major surgery. She sailed through the first round of chemo, and we expected, perhaps naively, that the second round would follow suit. Alas, that was not to be the case. Even though Cytoxan didn't affect her the first time through, for whatever reason it slammed her during this second course of chemo.

Gradually Maggie is improving, but if the symptoms don't abate by Friday, we will make the hard decision to put her down. The oncologist doesn't seem that concerned: he goes by the old formula of "as long as they're eating and drinking," but we're not convinced, knowing this dog as well as we do.

Maggie Update

One month into chemotherapy, Maggie is thriving. She had an ultra-sound on Thursday, and she is completely clear: no tumors, no swollen lymph nodes. We're astonished and delighted. She has weathered four treatments with little more than occasional lethargy and a runny tummy, the latter easily remedied with a half-dose of Immodium. Even the dreaded Doxyrubicin exerted little untoward effect: the following day, Maggie bounced around the front lawn with Chloe and bolted her food.

Mags did lose weight about two weeks into treatment, a loss she could not afford on her already painfully thin frame. Frantic, I increased her meals to three times a day, giving her generous portions of salmon, high-quality dog food, and even rice when her stomach was a bit loose. A small bowl of ultra-rich vanilla ice cream at bedtime provides additional calories, not to mention untold pleasure. Every dog I've owned loves ice cream--they'd eat themselves silly on it given half a chance. My efforts are paying off. Slowly Maggie is gaining weight and looking more herself.


It's a cliche about every day being a gift, but so often we take our beloved pets, like our family and friends, for granted, expecting they will always be around. We know that remission won't last long, but as Rod says, we'll enjoy every extra moment we have with this lovable, affectionate dog. And who knows? Rod met a man the other day whose dog was diagnosed with the same virulent form of Lymphoma that plagues Maggie. That dog too was given 4-6 months with treatment but is still in remission a year later and doing just fine. Maybe Maggie too will beat the odds.

Maggie

After a hiatus of several weeks, I've returned to blogging.  Life got in the way: a terminally sick dog, a chronically lame horse, and a far too demanding job.  

Maggie, our sick pooch, occupied much of our time in February. Fine one day, she couldn't keep anything down the next.  The first well-meaning but doddering vet prescribed antibiotics. (Query to husband: how will the dog keep down antibiotics if she's upchucking mere water?) By the third day, Maggie was admitted to hospital and put on an IV drip.  Little changed.  By the sixth day, the vets decided to do exploratory surgery, suspecting a blockage of some sort.  We imagined a golf ball wedged in her guts, a decayed remnant from the days when our neighborhood used to be a golf course, many decades past.  We were dismayed to learn the culprit was the size but, alas, not the stuff of a golf ball: the offending tumor was removed, along with a section of the large intestine.

Maggie was given a 50/50 chance of making it through the weekend.  She went into surgery early on Friday morning, the 8th of February.  By Sunday we began to hope.  A few days later, emaciated and weak, she was released back into our care; that same day we learned the tumor was malignant. Maggie was diagnosed with lymphoma, an incurable cancer.  She would live another 4-6 weeks at best unless we intervened with chemotherapy, something we had never imagined undertaking with a pet.

We asked for further testing.  It seems that poor Maggie can't get a break: the tumor was staged as large T-cell lymphoma, the most aggressive kind. Even with chemotherapy, she will most likely live 4-6 months from the time of diagnosis, giving her until the end of spring or beginning of summer.  Of course, she could once again beat the odds.  As the oncologist noted, she was sufficiently plucky to survive the surgery, and she just might make it until the end of the year.

We're now two treatments into chemotherapy.  Initially, I was opposed, but our family vet urged me to reconsider, arguing that Maggie was a good candidate given her resilience and relatively young age.  And I couldn't stand Rod's misery.  He was fond of his old terrier Scruffy, but Maggie is something special, the canine love of his life.  Smitten from the outset, Rod has doted shamelessly on this lovable albeit occasionally difficult dog.  He just can't let her go--not yet.

So far, so good.  Except for a bit of lethargy, Maggie has sailed through chemo.  We're even seeing a bit of the old bounce.  Last night she drove a herd of deer from our lawn and swaggered back into the house, immensely proud of her efforts.  This morning she stares belligerently out of the cathedral window, growling warnings to wayward crows.  I'm worried about the fourth treatment, when she will receive doxorubicin, a brutal drug, but I'm trying to take it a week, nay, even a day at a time, no easy task for someone of my anxious and admittedly controlling nature.