Changes

It may be my imagination but I think I am starting to see some subtle changes in Bella.  Yesterday I noticed that her stool was a bit looser than normal.  Dr. Wonders mentioned that diarrhea was a possible side effect of the Predisone.  I am also seeing a change in her breathing.  It seems more labored at times...like she can't quite catch her breath.  A few days ago Sherry said she thought Bella was struggling to breath and sounded like she was trying to clear her throat.  Otherwise she's acting pretty normal.  Still eating and drinking normally and still retrieving tennis balls.

If you watch this video you can see her rapid, shallow breathing.

Today was a decent day for Bella.  The Kubota dealer came to pick up our tractor for service and Bella and I walked to the barn to meet the driver.  Bella brought a rock to me and dropped it at my feet.  The driver watch me throw the rock for her to retrieve and was amazed that she could bring back the same rock over and over.  He said, "She must be able to smell it".  That seemed like a massive statement of the obvious, but I guess if you haven't been around bird dogs, it must seem like a bit of magic.

This morning Bella came to my office and sat beside my desk, trolling me to pet her.  I obliged her and leaned down to kiss the top of her head.  Her musty smell, earned through doing everyday dog things, greeted me.  I wish I could bottle that smell and save it for those times, coming soon enough, when she's gone and I am missing her.  I wish I could bag her loose hairs that are everywhere in the house and that will eventually be vacuumed away forever. But as sure as the sun rise itself, eventually all physical traces of my sweet girl will be washed away and I'll be left with nothing but memories.

Time

Its been about three weeks since we learned about Bella's condition.  I think about her life every day, wondering how much time she has left and what is going to go on in the last part of her life.  I ask myself at what point will she begin to feel something different in her body?  Will it come and go?  Or will the effects of the cancer set in permanently, faintly showing itself to her at first, maybe not really painful, but an unmistakable sign that something has changed? When will her quality of life begin to slip away?  I wonder when she comes to me if it is just for attention or is she asking me to take away the odd new feelings she may have. 

For now she still seems fine; the only sign I'm seeing of any change in her is a slightly diminished athletic ability.  She seems to tire a bit more easily when retrieving her tennis ball.  So we cut her sessions short and maybe do fewer sessions each day.  But eating, drinking, pooping all seem normal.  I see and hear no signs of distress or breathing difficulty.  And so far she's handling the Prednisone without any reaction. She goes back to the vet on 2/22/19 so we'll see what he says.

There is one other thing.  Bella has developed a habit of whining.  I think that this is her way of begging for treats but there's a possibility that she's crying as a result of discomfort.   I do know she's doing it more frequently.  Have to keep an eye on this.

This morning I went to my office as I usually do.  Bella followed me in and laid down near my desk, as she often does.  I watched her resting, breathing.  She's such a beautiful girl and I will miss her when she leaves. We have a little bit of time left.  I hope to make the most of it and to keep her as comfortable and happy for as long as I can.

Predisone

          “The bond with a dog is as lasting as the ties of this earth can ever be.” 

               – Konrad Lorenz


Mid week Sherry and I re-examined Bella's lymph nodes and agreed that they were growing.  We also noticed new lumps, larger than the lymph nodes in her throat, just off her shoulders.  I also discovered a lump in her left hind leg, positioned in the same place as the one we noticed previously in her right leg.  It seemed clear to us that things were changing and she should be seen asap.

I called the vet and got her into Dr. Wonders.  He agreed that things were developing and recommended that we start her on Predisone.  And so we did.

Bella had a good week, showing no signs of any sickness.  She retrieved tennis balls every day and showed a little bit of slowing down, though I suspect it might just be advancing years and not cancer.

So we now know that her cancer is spreading and that we have a chance of slowing it down.  Predicting her remaining time is difficult, but Dr. Wonders thinks she has a few months before her quality of life degrades to an unacceptable level and we are faced with the last decision we'll have to make about our sweet girl.

762

          “The pain passes, but the beauty remains.” 
                   
                   – Pierre Auguste Renoir

This morning Bella and I went out to "play catch"...that's what we call it when I chuck her tennis ball and she retrieves it.  It was a beautiful morning, clear and cold.  She made a half dozen retrieves and then decided to sit down on the hillside with her ball in her mouth, looking back at me.  I thought it was odd, but I never push her in these situations.  When she wants to sit, she sits.


I approached her and asked if it was all OK.  She remained sitting and I decided our session was over.

"Wanna get a treat?", I asked.

Her ears perked up and she stood.  We turned for the house and she ran ahead of me, albeit at a pretty slow pace.  She hadn't worked hard enough to cause this slow pace...was it old age?  Was it the cancer?  I admired the silky feathering on her rear legs, knowing that I'd see that a limited number of times.  I thought about the end approaching and my eyes welled up.

This is only going to get tougher.

We came in the house and I wondered if the warm air felt good to her.  I gave her a treat and she followed me to my office, pausing in front of my bathroom where she often took a drink from my toilet.  Hey, she's a dog.   Before every drink I flush the toilet for her, my attempt to give her the cleanest water possible for a toilet.  I thought about how many times I'd done this for Bella and wondered what the actual count was.

For reasons known to no one, the number 762 popped into my head.  Was it 762?  No, it has to be more times than that, probably in the thousands.  Hell, she's been alive for nearly 4,000 days and this is a nearly daily routine.  So 762 must be way low.  Still, it is some number.  And there are a finite number of flushes ahead for us.

This I know to be true.

Our Precious Gift

“To call him a dog hardly seems to do him justice, though inasmuch as he had four legs, a tail, and barked, I admit he was, to all outward appearances. But to those who knew him well, he was a perfect gentleman.” 

       – Hermione Gingold

Retrieving her tennis ball

Today we locked in on our treatment strategy for Bella's lymphoma.  We have decided that we will not do chemo and we will treat her symptoms with Prednisone.  Note that I say "treat her symptoms" because that is all the Prednisone will do.  In a sense that's all chemo does for her...there is no cure, nothing will do anything other than reduce the severity of her symptoms, put the cancer in remission and hope to buy her time.

Where's the ball Dad?

We met with Dr. Wonders this morning and reviewed the treatment options...mostly for Sherry since she hadn't visited the vet since learning of Bella's diagnosis.  We walked through the two options...chemo (the "CHOP" protocol) and Prednisone.  There was nothing new here and we told Dr. Wonders that we'd decided not to do chemo.  He thought our decision, based on his experience and Bella's diagnosis, was a good one.  He asked to see her again on 2/22/19 or sooner if her situation changed.  At that point we'll decide whether to start the Prednisone or further delay it.

Our decision was based on a number of things..  First of all, the extraordinary cost of chemo is an issue for us, particularly since chemo only guarantees that she'll eventually slip out of her remission and die from her cancer.  Aside from that there is the burden of driving her to Atlanta for her treatments, stressing her with trips to a strange place full of odd smells and sounds, producing toxic waste that we'll have to dispose of and risking that she'll become sick from the poisonous chemo.  And with all of these downsides, there is the certain knowledge that she's going to die from it all anyway.

More bad days for us, more bad days for her.   Its no bargain.

Sherry and I are in complete agreement on one thing, that we will pull the plug on her at the first sign of distress or suffering.  As our friend Kyle said, protecting her from suffering is the most precious gift we can give her.

A Perfect Sunset

 “Dogs leave pawprints on our hearts” 

        – Author Unknown

After dinner tonight Bella came into my office and sat next to me.  I began stroking the silky fur on her head and talking to her in soft tones about nothing in particular, calling her, as I often did, "my sweetest girl".  She looked up at me with her imperfect brown eyes, one clear, one cloudy.  From my western facing office window I noticed a sunset blooming and suggested to her that we go watch the light.

We sat on our front porch and looked out at the smear of blues, yellows and oranges spreading across the western sky.  Bella sat to my left, her hind end flush against my side.  I can't say whether Bella was watching the psychedelic sky or was just pointing her muzzle into the air to savor the scent of the fresh chicken poop our hay guy had spread on the pastures over the weekend to give our grass a boost. It didn't matter, I was enjoying the moment and slowly stroked her head and neck.  I dipped my hand to her throat to see if the deadly growths were still there.  

The sky caught fire in front of us and the living colors that stretched for miles were magnificent, morphing in real time before our eyes.  I knew full well that the show wouldn't last long...that this  light, that had traveled millions of miles to arrive at this instant, would soon slip away, never to return.  The best I could do would be to enjoy it while it was there and to do my best to remember the moment.

Before it died out and the sky turned ashen, the colors intensified one last time and spread across most of the sky.   The yellow shifted to orange, the orange to red, the red to maroon.  We listened to a flock of roosting doves noisily clatter their wings against the dry leaves in the magnolia tree next to the house.  Bella's ears lifted and her head turned slightly to the left to monitor a truck going up our road.  A pair of doves circled around the upper pasture and disappeared over our front woods. The temperature dropped and I pulled Bella closer.

Within minutes the colors in the sky began to slowly recede and soften, losing their intensity.  Cloud after cloud shifted from pale blue and orange to gray; the life in the sky seemed to drain away as the brilliant color shifted to monochrome. The sky began its relentless transition from light to dark.  It was a fitting way to celebrate the end of a great day, her beautiful life and her incredible connection to our family's lives.

It was a perfect sunset.

A Good Day

 “If there are no dogs in Heaven, then when I die I want to go where they went.” 

                  – Will Rogers

Yesterday was a very good day for Bella.  She still shows no signs of anything being wrong and ate and exercised as normal.  Nick and Krista drove down from Chattanooga in his new Ferrari to show us his amazing car but also (I think) to be sure to see Bella at least one more time before trouble sets in.  It was a very good day for us all.

We enjoyed our best friends, the Campbells, over a great dinner at Mama G's.  It was nice to enjoy the company of friends our age along with Nick and Krista who relate to the Campbells as comfortably as we do. The conversation at the table was animated and engaging and full of laughter.  I was grateful for a chance to take my mind off the gloomy outlook for Bella for a couple of hours.

We drove home in the dark but it was still early and we all laughed and listened to music until fading out around ten.  Bella was long since in bed, having decided for herself when it was time.  With no fanfare, she quietly slipped into her kennel an hour earlier and fell asleep.  Before I retired I gave her a treat and told her I loved her.  Sherry and I watched "The Wire" for half an hour and then fell asleep ourselves.

It was a good day.

Lymphoma

“Sometimes losing a pet is more painful than losing a human because in the case of the pet, you were not pretending to love it.” 

              – Amy Sedaris

Bella's vet called me this afternoon and delivered the news we feared.  She has a high grade (fast growing/aggressive) large cell lymphoma that starts in her lymph nodes but will likely spread to her spleen and liver.  Left untreated it will kill her in weeks, so it is as bad as we thought it might be.

Had we not noticed her swollen lymph nodes, we'd have no idea that she has a terminal illness...she acts completely normal and retrieved tennis balls, took a walk, ate her food and treats as normal.  I suppose many people and their dogs simply sail right into the late stages of cancer blissfully unaware of what the future holds.  Unfortunately we KNOW and will soon have to  begin making decisions about what to do next.

I have asked her vet to refer us to an oncologist nearby to understand what's involved with chemo....costs, side affects, schedule of treatment, likely remission, etc.  Hopefully we'll get to do this early next week.  Time is of the essence;  I know that this fucking disease is doing its best to kill her RIGHT NOW.

I've spoken to Nick and Sherry and will soon talk to Jon about this.  I want them to understand that Bella is OUR dog, not mine and this is a decision that we should make together.

In the meantime, Bella seems completely unaffected- she's eating, pooping, drinking, sleeping and exercising normally.  We've been taking long walks at the farm and she's retrieving tennis balls the way she always has.  She bounds out of her kennel in the morning like a young dog and eagerly attacks her food bowl and begs for treats.  So far her quality of life is at 100%.