Charlie's chemotherapy

Yesterday morning Charlie started the chemotherapy protocol recommended by Dr. Dernell at the CSU Animal Cancer Center. I dropped him off at the local Tiara Rado Animal Hospital, where they took a chest x-ray and an echocardiograph to check for metastasis in his thorax and provide a baseline for his treatment. He was clear but there were two heart abnormalities: an 18% thinning of the left ventricular wall and a bunching of that ventricle's papillary muscles that almost looked like a tumor on the echocardiograph. Dr. Marquis is not sure if these conditions are related to Charlie's cancer but he was concerned because the Adriamycin that is a component of the protocol is known to cause ventricular thinning as a side effect of treatment. Dr. Marquis recommended that when Charlie returns in three weeks for the second treatment, with the Carboplatin component of the protocol, we should repeat the echocardiograph to check his heart. If there is additional thinning, we may need to look at alternatives or possibly abandon the chemotherapy.

We weren't sure what to expect after the first treatment, but when I picked Charlie up in the afternoon, he was his usual self, so happy to see me that he leaned into my legs and moaned. We went for a walk when we got home, and his endurance was the same. His appetite was good as well, so he doesn't appear to be showing any adverse side effects. If his heart holds up, the chemotherapy may work well to keep him comfortable and prolong his life. I'll keep you posted.

Charlie's diagnosis

Our worst fears were realized on Thursday evening when we received a call from Dr. Dernell. The results of Charlie's biopsy came back positive for osteosarcoma. Nan and I both took the news badly. It meant that there was no cure; the disease was going to kill him, probably within a matter of months. The traumatic surgery we had hoped would remove all traces of the tumor now seemed cruel if it was only going to gain him a few months, so we have opted not to put him through it. Instead we are going to begin a cycle of chemotherapy as soon as possible and hope for the best. If it slows the growth of the tumor and its metastasis, Charlie could survive as long as eight months.

We met with Dr. Dernell and Erin yesterday at the Animal Cancer Center in Fort Collins to discuss Charlie's future before driving home. They cautioned us that while he may be his normal self right now except for the tumor and the bad breath, he would soon start to experience persistent pain and associated changes in behavior. We agreed to enlist whatever palliative measures we could to keep him comfortable. They said we would see a gradual change in his attitude about life, that his focus would shift from the joys of eating, sleeping, chasing tennis balls and going for walks to a fixation on his condition and a loss of interest in everything else. At that point, he would begin the process of dying and we would need to consider ending his suffering instead of prolonging his life.

I can't even write these sentences without crying. I can't believe that just a month ago Charlie's life seemed to stretch out into the foreseeable future and now it will be over in less than a year. The best we can do is make the most of our remaining time together, giving him as much love and attention as possible, which is how we should all live our lives with each other no matter how much time we have.