Jack's Journey

A quick visit to our regular vet at Bradford Veterinary to get the fentanyl patch placed for surgery the next day.  Jack loved the attention that the vet techs gave him.  After that a stop at Hannafords to get a rotisserie chicken (his favorite) for dinner.  He knew something was up when I wouldn’t stop taking pictures of him before he went to bed…oh and all the tears were a dead give away as well. 

Bright and early Friday January 23rd, we woke up, went through our regular routine (minus breakfast and pills).  Things got really fun for Jack when he was told that he “gets to go”.  Music to his ears!!  Jumping for joy, he couldn’t contain himself.  Little did he know!

We arrived at SAVES in Lebanon, NH at 8am.  Turns out that Dr. Kelly followed us there (and quickly turned around to leave for a farm emergency).  We met with Dr. Hess and discussed the sequence of events, how they were going to do the surgery (remove the scapula vs. not), cutting muscle vs. cutting bone.  We had a quick tearful goodbye, he went out one door and I went out the other.  In the parking lot with tears streaming down my face, I hear, “Miss, Miss”.  I turn around and they tell me that I need to pay the deposit (about $1200).  Isn’t keeping my baby, removing his leg and tossing it in the biohazard waste enough of a deposit?  Anyway…I paid the deposit (gotta love Care Credit) and left.

Noon came and went with no phone call, finally I called after two.  Turns out they called and left a message at my house instead of reaching me on my cell or at work.  I went straight to work after I dropped him off to keep my mind off of what was happening and I didn’t want to take time off if I wasn’t actually going to be with him.  Surgery went well, no problems.  They asked if I wanted to send out some of the leg for Pathology.  I said no.  I’d already paid $1300 to detemine that it was osteosarcoma and had the leg removed, I didn’t see any value in sending it for more Pathology.

That night I went out!!  We had a big going away party for a coworker and had drinks and listened to live music at our local Elks Lodge.  Jack was being taken care of and tonight was my one last nights of freedom for awhile.  I checked in with them every couple of hours to see if he had peed and pooped, ate or walked at all.  On my way home from the bar at 11:30, I called and spoke with the vet tech.  I wanted to see how he was doing and make sure someone was there, awake, taking care of him.  She said that he  pooped, ate and peed.  He was getting around amazingly well and was a complete doll.  She was letting him lay on a blanket next to her instead of in a crate.  Aaaawww…that’s my boy!!

Sleeping that night was too quite.  Even the cat, Chloe missed him.  Saturday morning I had some errands to run before I headed to Lebanon to pick him up.  I knew he was in good hands and the longer he stayed there the better it would be for him.

My aunt Elaine came with me to pick him up.  I walked in and said I was there to pick up Jack.  Before I could even get the word Jack out of my mouth, I saw his butt on the floor behind the receptionist.  I dropped everything and went to see him.  His tail was wagging and he was happy to see me but didn’t know how to move to show me that he wanted to be near me.  He started panting and couldn’t get comfortable.  The tech explained this was a sign of being in pain.  We all sat on the floor in the reception area (me, the vet tech, Dr. Hess and Jack) and discussed the piles of medication and discharge instructions.  As long as I didn’t move and was touching him, Jack was fine.  I paid the remainder of the bill (this time before I got to the parking lot) ~ $500 and we walked outside.  Jack did great; even the vet tech said that when she came in she thought he was 3 days post amputation vs. day after.  We both lifted him into the back of the car, got him settled and headed home.

Next step…get him out of the car!!!

The girls at SAVES decorated his bandage with hearts cause they all loved him so much.

Received  a phone call from Dr. Schultz at work.  Funny that I couldn’t remember where or how I knew Dr. Schultz until I heard his voice.  Pathology reports came back and it was in fact osteosarcoma.  My smallest glimmer of hope that it could be a fungal infection was gone.  I think I took it well, My response was, “so now we cut his leg off?”  He said yes, though he wouldn’t put in the same words.  We ended the conversation that his assistant would be in touch with me with an estimate to perform the amputation.

Hours later, I still hadn’t heard from them.  My type A personality was kicking into overdrive!!  How was I supposed to plan my life over the next couple of months?  Finally, I couldn’t wait any longer; I called them.  I spoke with Alicia and asked her to send me an estimate.  Peak has a policy that they do not give out estimates via email or fax.  Since I was an hour away, this was not an acceptable answer.  Verbally, she quoted me $2800 – $3300 but wouldn’t give me the exact breakdown of individual costs.  My emailed quote from my regular vet was about $1,000.  Big difference!!!  I mentioned this and her reply was that I was comparing amputation at a doctors office vs. a hospital.  I had faith in both, the only must was that he wouldn’t be left alone the night after his surgery.  I wanted someone there to be able to give pain meds if needed, check vitals and just provide human contact.  This was non-negotiable for me.  My local vet could not provide this, while Peak could.  Tears of stress started flowing…while you don’t want finances to be a deciding factor, the reality is they are.  So what did I do?????  Called Mom!!!!!!!!!!!!!!!

It’s hard to have a phone conversation when you are crying and can’t talk, but my Mom is so amazing that she just listened to me crying and offered words of encouragment.  She suggested that I contact the emergency vet in Lebanon, New Hampshire (SAVES).  She had taken her golden Harley there for emergency surgery and was very impressed with their vet, Dr. Dan Kelly.  I called them.  They took my information and said they would call me back.  Still stressed!!!! Headed home and as soon as I was with Jack the stress melted away; isn’t it amazing how they can do this for us humans?

Dr. Hess called me that evening, took my information and provided me with a very detailed surgical plan and quote ($1700).  SAVES is a 24/7 emergency vet and staffed with a vet and vet tech overnight.  This met my non-negotiable. We were on the phone for at least 30 minutes.  She did all this without seeing a single xray, lab value or even Jack.  We scheduled the amputation for Friday January 23; 8 days away.  Next step ~ have fun, play ball, visit friends; make the most of each day.

At our appointment at NEVOG, Jack received prescriptions for Rimadyl and Tramadol.  The Rimadyl, an NSAID for inflammation and the Tramadol, an opioid pain reliever.  One week on both of these medications and Jack is acting like a one year old puppy!

Now we were onto our first visit to PEAK Veterinary Referral Center with x-rays and labwork in hand.  We met with Dr. Kurt Schulz.  We discussed options besides amputation. This included removing the ulna bone (this was the bone that the cancer had eaten away at) and keeping the leg or removing the ulna bone and placing a rod or bone graft in it’s place.  Dr. Schulz did not recommend either option; he said that often infection sets in and sometimes they after all that they amputate anyway.  We also discussed the urine test for the fungal infection that could be causing the lesion of the bone.  The urine test was over $200.  I decided against it.  We talked about the biopsy and how it could be inconclusive.

The game plan was to have Dr. Schulz perform a tree? biopsy.  He would use x-rays to pull pieces of bone in the correct spots that would give the best possibility of results.  The biopsy was described to me as being like a bone marrow biopsy in humans.  A large hollow needle twisted into bone and a corkscrew like device that is screwed inside it into the bone that pulls out bone.  If if sounds painful, let me tell you it is!!!  I had a bone marrow biopsy done 15 plus years ago and would never have another unless I was completely under.

They took Jack for the procedure and I was all happy like he was going off to play with friends.  I’d learned over the last couple of days how much he takes cues from me.  I’m his alpha dog and if I’m happy, then he is, if I’m sad or scared, most likely he is too.  This was important for me to realize and keep in the forefront of my mind when making decisions.

Four hours later, Dr. Schulz called and said he was all set, the biopsies went well, there was more hemorrhaging than he thought there would be so he was going to prescribe antibiotics.  I picked him up, front leg wrapped in a tractor bandage, his prescriptions, used Care Credit to pay for the $1300 biopsy and we headed home.  This was the first time I wondered if I had made the right decision; my baby boy who had a limp every now and again with a lump on his leg now would not put weight on the leg and was limping quite badly.  Doctors orders were to lay low, no running, jumping etc…basically no fun, no being a dog!  All we could do now is wait for the pathology report…Jack on “his” couch that night.Two days post biopsy, I could have removed the bandage but it was holding up so well and he wasn’t bothering with it, so I left it on.

Three days post biopsy.  Six staples, very little swelling, putting weight on the leg and acting normal.  Bandage off and Jack isn’t really messing with it.

As we all know, life doesn’t stop for cancer; laundry needs to be done, alarm clocks still go off bright and early and bills still need to be paid.  First thing Monday December 29, I called Peak Veterinary Referral Center; a multi-speciality hospital about an hour north.  We set up an appointment for Wednesday with their oncologist.  I was feeling better, more in control; I had a game plan (it’s my OCD, type A, gotta be in charge personality)!

Later that day, PEAK calls me back and says that their oncologist had her baby (6 weeks early) and there wasn’t another oncologist to see.  I was then referred to NEVOG ( The New England Veterinary Oncology Group) in Waltham, MA.  Our appointment was set for Friday January 2nd.

My sister agreed to ride along with me to Mass.  It was kind of a big deal ~ she’s not animal person….at…all.  She is however, a physician assistant, so it was nice to have another person at the consult who understood all the medical lingo.

Jack was super excited to go for a ride that morning.  Every time I tell him that he can come with me, he turns inside out and flips out like a teenage girl at a Bieber concert.  Lauren came along as well.

We met with Dr. Gabrielle Angelo.  While we were in the room filling out paperwork, another Golden came in, then another, then another; that was eye opening to see.  Four Goldens, various ages, all being see at a Veterinary Oncology clinic.

Dr. Angelo was very knowledgeable and thorough.  We discussed fungal infection vs. cancer.  She discussed case with her fellow vets. She explained that the lesion was on his ulna, a non weight bearing bone.  This was a good thing and probably why he hadn’t broken his leg yet.  We decided to do some basic blood work – CBC and chemistry panel and have a Radiologist review his chest/abdomen x-rays to confirm it hadn’t metastasized.  I was most concerned about his alkaline phosphatase level.  I’m a medical technologist – labwork is what I do.  I knew that a high alk phos was not a good thing.

Labwork was NORMAL!!  That’s my boy!  Perfect!  They offered to do a punch biopsy to confirm cancer but I didn’t want to stay longer (we were two hours into our appointment).  While in the exam room, I called PEAK and talked with their surgeon, Dr. Shultz and he said there was a 10% chance that it was a fungal infection. 10% was enough of a chance to do a biopsy before amputation.  My new game plan was to go to Peak for the biopsy.

Three hours later, we left NEVOG overwhelmed with information and a $460 bill.  A quick stop at Costco and we started the three hour drive home.  Lauren watched movies in the backseat with her Ipad and headphones.  A few times I caught Jack watching the movies too and it melted my heart.

This  was Lauren in the backseat with her muffin for breakfast.

Just before Christmas, I noticed a lump/bump on Jack’s front left leg.  It was hard, slightly warm, but he didn’t mind when I touched it.  He wasn’t limping, licking or doing anything to it.  It was just there.  We were still playing fetch with our brand spanking new LED tennis ball (http://www.amazon.com/Nite-Ize-MTLP-08-03-MeteorLight-ball/dp/B001QC0JRU) every night.  Life was good!

We saw our vet at Bradford Veterinary Clinic (http://bradfordvet.com) on December 27, 2014.  Dr. Dyer said, let’s take some x-rays.  My 3 yr old neice and 5 yr old nephew were with me and very bored.  Jacob is not really an animal lover and his sister Lauren is exactly opposite.  I was trying to keep them busy and out of trouble when Dr. Dyer had me come in another room to see the x-rays.  She said, “it’s cancer”.  My stomach dropped, my entire face felt flush and I didn’t say anything.  She continued on…”treatment is amputation”.  I remember asking questions with no emotion, looking at the kids who were fighting about who would hold Jack’s leash.  Jack, on the other hand, was just laying on the ground waiting to go home.

She suggested x-rays of his chest/abdomen to determine if the cancer had metastisized.  More waiting…more bored/impatient kids…more thoughts running through my head ~ not a good combination! By then I was crying; I don’t know why I didn’t think that it could be cancer, but it never crossed my mind.

Finally, a tech came in and said the chest/abdomen x-rays looked clear. Phew!  $268 later, I loaded up Jack, Lauren and Jacob.  I didn’t stick around to wait for the amputation estimate, I asked them to email it to me.

The ride home was quiet, long and full of tears. (mostly on my part, but a few from Lauren; she was scared that I was crying and didn’t know what to make of it).

Next step – Get these kids back to their Mother so I can focus on my kid!

Jack was born April 11, 2006.  He’s a Chelsea dog; meaning he’s from the country.  In his first life, Jack’s Mom was Katie.  She was excited to have a beautiful little puppy and boy was he beautiful.  He spent his first nine months growing up in Washington, Vermont, also the country, but didn’t have as much freedom and attention as he wanted.  I met Jack through my sister Sara (Katie’s sister-in-law).  It was early 2007, I had just finished up three years of traveling as a medical technologist, had purchased a home two years earlier and was ready for the responsibility a dog would require.  I just didn’t have a dog…enter Jack.  He became mine in March 2007 and moved from Vermont to New Hampshire.  Finally, my fenced in backyard had a purpose!!

Jack learned to love the outdoors; making snow angels, playing fetch, going for walks, learning tricks, lounging in his kiddie pool and chasing water from the hose.  Jack became best friends with his “aunt” Harley (another Golden Retriever).

Fast forward to 2009, Jack and I moved back to Vermont and the country; no more fenced in backyards!  We lived with my Mom and her puppies while my house was being built.  Mom is a “puppy raiser” for Freedom Guide Dogs.  Her first puppy was Kip, a yellow lab.  Kip idolized Jack and everything he did including peeing like a girl dog.  Cinder was her second puppy, a black lab, smaller but smarter than Kip.  Cinder also idolized Jack along with chewing on his ears and putting herself in the middle of his personal space.

In January 2012, Jack and I moved into our new house.  It was just down the driveway from Grammy’s.  Thus began Grammy’s daily routine of coming over to get Jack for an afternoon of playtime.  Instead of Doggie Daycare, it was Grammy Daycare.  At the end of the day, Jack would spy me coming down the driveway and follow me home.  Life was good.