one of the roughest weeks of my life

My last post was one week ago, just hours after hearing that the lump I found on Curzon's ribcage was likely to be cancer.  The past week has been a rush of tests, crying, research, results, photos, play, decisions, and surgery, and it's been a ride that I hope I never have to repeat with anyone (human or canine).

After the initial pathology report indicated cancer, my vet referred me to Seattle Veterinary Services (SVS) in Kirkland, and I spent Wednesday morning working to arrange a consult with their specialists there.  We took Curzon in on Wednesday afternoon, and discussed our options for surgery (later discussions about chemotherapy, herbal treatments, etc. will be with their oncologist).  Based on the location of the lumps, a rib resection was recommended that would remove the tumorous rib with a clear margin above and below, plus the ribs to either side.  The prognosis for this surgery is good, as dogs easily adapt to the loss of up to five ribs, and the surgeon expects Curzon to be able to run, swim, and probably even play flyball again after he's completely healed.

On Thursday I took him in to get the blood panel worked up, and the results were in just a few hours later.  Thankfully all of his labs were excellent, with every single value right in the middle of the "normal" range, and the all-important alkaline phosphinate (ALKP) level located in the low end of normal.  This is important because osteosarcoma patients with elevated ALKP levels have a much poorer prognosis with faster metastases and shorter median survival times.  While that doesn't mean it's not still osteosarcoma, it is an encouraging sign that we might be dealing with a less-virulent chondrosarcoma.

On Friday, we took Curzon to a different office (Veterinary Radiology in Mountlake Terrace) to have a CT scan done to assess the exact location and extent of the tumor, as well as to determine if there were any visible metastases.  This involved a sedation for the scan and also a biopsy of the tumor, so we were there for a few hours during the procedure and recovery phases.  The scan showed that the tumor was a bilobed tumor across the lower portion of rib 3 on his right side, confined to the single rib and comprising both the cartilage and bone parts of the rib.  Thankfully, absolutely no metastases were present in his lungs or other organs, with all of them looking in excellent shape.  In the picture below, cropped from one of the CT scan images, you can see the tumor on the rib in the lower right-hand section.

It was really super cool to see the CT scan results, and get to look all through the inside of my dog, although I wish it wasn't for such a serious reason.  They gave us a CD of the basic images (though not as cool as the modeling/rotating software the doctor was using) and it's absolutely fascinating to me.

Monday was our final surgical consult and decision point with the surgeon at SVS.  When we arrived (straight from work, as we didn't need to bring Curzon), we were told of a very frightening prospect - the final detailed report from the CT scan showed a possible mass around the vena cava veins in Curzon's liver.  There wasn't enough detail to determine if this was the case, so they asked us to bring him in for an ultrasound right away to check it out.  We rushed home, grabbed him, and rushed straight back to the vet for the procedure.  A short time later, the results showed that there are no tumors in his organs - liver, kidneys, and adrenal glands are all clean and he has an excellent bill of health.  With all of that information, we decided to move forward with surgery on Tuesday.

On both Friday and Monday, I was very lucky to have friends willing and available to help take lots of pictures of Curzon's favorite activities.  The pool and outdoor pictures (except the one above) were taking by a friend, and I have a whole album of them with some really great shots on my Facebook page.  The photo above was taken by my friends at Artis Photography on Monday afternoon, which is usually their day off but they came in to do the photoshoot before Curzon went in for surgery.  No matter what the final outcome, I will forever be grateful for my friends for helping document his favorite activities before such a scary step as surgery.

 

I took Curzon to SVS yesterday morning and left him there for his surgery. He was an utter charmer to the staff that morning, trying to use his leash to play tug with the male tech who came to take him back for checkin, and doing several tricks to the delight of everyone there.  Leaving him was one of the hardest things I've ever had to do, knowing what surgery was going to do to him in the short-term even though it is for his own long-term benefit.

The surgery took place between about 3pm-6pm yesterday, and was successful in achieving the goals of a clear margin around the tumorous rib.  The surgeon was able to manipulate his muscles to form a nice covering over the "hole" left by the removed ribs, and it's all tucked up under his front leg which will provide additional coverage and protection during and after the healing process.  He's got a bandage and a compression-style coat on right now to help minimize movement and assist the tissues in knitting securely.

We visited SVS in the evening yesterday to bring him some premade raw meals and check on how he was doing.  He was only a few hours out of surgery at that point and was sedated and resting comfortably, so we did not go back to see him in order to avoid riling or disturbing him.  The wonderful nurse on duty took my phone back and grabbed some pictures of him, including this one...somehow, the opiate-induced nap doesn't look so bad when he has a warm blanket and a pillow!

Curzon has a chest tube in to help the wound drain, and we are hopeful it will be removed today so that he can come home tomorrow since they prefer to keep him for 24 hours after the tube removal.  We are putting together a "recovery area" for him at home with an e-pen, a new comfy bed, towels, and so on that we can adjust as his abilities improve.  Of course, he'll be sleeping for the next several days...so our biggest challenge this weekend will be convincing Ezri that no, Curzon can't come out and play with her yet!

On a completely unrelated topic, last week I ordered a "Grab Bag" baby unicorn from Windstone Editions, which is a random sculpture hand-painted in a fantasy color/pattern scheme by Melody Pena herself.  The designs ran the gamut from zebra stripes to butterfly patterns, with colors ranging from pastel to brilliant neons, and all are amazing.  Mine arrived yesterday, and was a welcome bit of bright happiness in my day - I think she's quite lovely, and I'm thrilled to have my first signed Windstone sculpture, even if she's not a dragon.  Right now I'm keeping her on my desk at home, where I can see her bright colors and pretty purple raindrops for most of the time that I'm home.