Friday, December 25, 2015

Update on Scout

Scout and Nan at Harbour Town Marina last Saturday
The meeting with the veterinary oncologist instilled new hope for Scout's prognosis. Dr. Daters discussed the options with us and convinced us that surgery to remove the pancreatic tumor would be the most beneficial. He said it would immediately eliminate the symptoms associated with the high insulin and low blood sugar caused by the tumor, namely the partial lameness, lethargy, and occasional confusion. He cautioned that the cancer would return eventually but probably not for a year or two, which for a nearly eight-year-old dog is a considerable length of time added to his lifespan.

Instead of the Sandostatin medication we inquired about for lowering Scout's insulin levels, Dr. Daters recommended Diazoxide. Scout started on it last Tuesday and so far, there is no change in any of his symptoms. He is still taking Prednisone, and we have added the pain reliever Tramadol as a consequence of the groaning he emits when I lift and carry him.

Scout does not appear to be in pain but rather in a state of perpetual frustration. Inside the house, it is almost impossible for him to attain a standing position without assistance because his hind paws slip outward and put him into an awkward frog-like position. He will sometimes use his front paws to slide himself around on the tile and wooden floors, but he gets stuck and whines when he reaches a rug or can't turn around. We have been using a towel as a sling under his belly to lift him to a standing position and walk with him to prevent slips and falls. Outside, there is better friction and Scout can move around more freely, though his back legs are shaky and his back paws are turned in. He does not have the energy for a walk, even to the end of the block, but he enjoys the warmth and stimulation of lying out in the sun.

Surgery is scheduled for Tuesday. It will be less invasive than we first imagined, no more than the equivalent of a spaying procedure. I told Nan I am hoping for a small miracle. It would mean so much to us to have Scout return to his former self, if only for several months or a year. This may be a rationalization but I want to believe that Scout would want to be back to normal as much as we would want it for him.

Sunday, December 13, 2015

Scout's health

Scout on Sunday morning, December 13, 2015
Scout has been diagnosed with pancreatic cancer. An ultrasound last Tuesday revealed the cause of his recent hypoglycemia and back-leg lameness: a ping pong ball-sized tumor in his pancreas. The tumor is causing Scout's pancreas to produce excessive insulin, which is driving down his blood sugar and causing the symptoms we at first suspected were related to his spine or hip joints.

His shaved belly from the procedure is the only visible sign in the photo I took this morning that anything is different with Scout. He still has the same wonderful personality he has always had, and his appetite is undiminished. We have been feeding him smaller meals more frequently to keep his blood sugar steady and augmenting his regular diet with high-protein foods like scrambled eggs and cooked chicken to give him longer lasting energy between meals.

Scout with Nan at Tybee Island on Saturday, December 12, 2015
We are still trying to accept that this cancer is terminal and that Scout will eventually die from it, just as Charlie died from terminal bone cancer almost eight years ago. As we did with Charlie, we are opting not to put Scout through surgery to remove the tumor. It would be invasive and traumatic, and it would merely slow down the cancer, not eradicate it, even with chemotherapy or other postoperative therapies. He might gain a few months but at the expense of a long recovery and a lower quality of life. We would be selfishly putting our desire to keep him in our lives for as long as possible ahead of his natural right to die with dignity in his own time.

Scout walking with John on Tybee Island - December 12, 2015
The best we can hope for at this time is to treat Scout's symptoms, particularly the lameness which has required me to carry eighty-pound Scout up and down the stairs and lift him in and out of the car. In addition to the feeding changes, we have him on Prednisone to help stabilize his blood sugar, and we want to look into an insulin-lowering drug called Sandostatin when we meet with a veterinary oncologist on Tuesday. Our thinking is that if we can lower Scout's insulin levels, which in turn would allow his blood sugar levels to return to normal, then he would be able to move around as before, resume the long walks he loves so much, and live out the time he has left as well as possible.