Tulip vs. Pneumonia followed by Tulip vs. Cancer, Round 2
A keen eye on my last post shows we went to the vet a lot during the three weeks of lockdown. At first I thought I'd caption this "Tulip's Health Problems" or something like that, but I decide we weren't going to bury the lede. Tulip has had a horrible five weeks of health issues so far, and there's still a long ways to go.
In late February, we noticed that Tulip wasn't eating as much as she usually does and had in fact lost enough weight to be noticeably thinner. We weren't particularly concerned, given that in the previous month we had painted the house, which put Tulip in daycare for most of two weeks in addition to other "my house is being rearranged" stress. That was followed quickly by Chucha's sudden illness and passing, which was followed by another stint in daycare while we were in Orlando. In short, that's enough stress to make even the most even tempered dog a little wigged out. Since we needed to get her annual physical and updated shots anyway, we scheduled a checkup for early March.
A few days before that checkup, Tulip started hacking. The vet confirmed that she had kennel cough. Given that her kennel cough vaccine was about to expire, she'd just been at daycare for most of three weeks, and she's a little older anyway, that wasn't a huge surprise. Somewhat more surprising was that he also felt a large tumor in her abdomen. A needle biopsy and an ultrasound detected a single large tumor on her liver. Shit.
Now, given that Tulip is 12 years old and most knowledgeable observers think she's part boxer (a breed known for getting cancers), this wasn't a surprise either, especially she beat round one of cancer on her knee back in 2015. So we got pile of antibiotics and painkillers for the kennel cough and the name of a canine oncologist to talk to after the kennel cough was successfully treated.
That last about four days. On a Tuesday night M noticed that she was shaking near uncontrollably and having a lot of trouble breathing so we spent an evening at the emergency vet (our third overall visit in less than a month). You know how older humans sometimes get a flu that they can't shake off that turns into pneumonia? Dogs are exactly the same. Tulip was admitted for IV antibiotics and painkillers after the chest x-ray showed her kennel cough had turned into pneumonia.
Fortunately, the overnight treatment worked wonders. She got a new course of stronger antibiotics (two kinds!) which worked better. She showed significant improvement, but when we reached the end of that course she still had some symptoms, which were much like a human flu in that they involved a deep hacking cough and some sneezing. Our regular vet took another x-ray, which showed the pneumonia was much reduced but still present, so she got even more antibiotics and a steroid to reduce inflammation.
After two weeks on those, she seemed to feel much better. She was certainly eating better - during the height of her sickness we were spiking her food with chicken and salmon and treats for every meal and even then she didn't always eat it, but at this point she was back to four cups of fancy dog food a day, which is good because she was down 10% of her body weight and looked very skinny. However, after a few days off the antibiotics, a few symptoms came back, and we decided we weren't fucking around. Given her advanced age and symptoms and the high probability that liver cancer is messing with her immune system, our vet prescribed two more antibiotics today, which he believes should flatten what's left of the symptoms.
Assuming that all works and the kennel cough / pneumonia combo is finally taken care of, then we can turn to the liver cancer. There are broadly speaking three options in cases like this:
[1] The cancer has spread everywhere and nothing can be done.
[2] The cancer is in one place now but spreads fast. Surgery or chemo might keep it from spreading.
[3] The cancer is in one place now and is very slow moving. Depending on symptoms, doing nothing may be the appropriate treatment.
The canine oncologist reviewed all the lab work and said that as far as she can tell our regular vet was correct in that there is one big tumor on the liver that has not spread anywhere else. This is backed up by the blood work, two ultrasounds and both of her chest x-rays, and it seems to eliminate option [1], which is obviously very good news because if option [1] comes up palliative care is really the only viable option for a dog of any age, let alone an elderly old lady dog. The most likely diagnosis is option [3], with a slim chance of option [2].
If it does appear to be [3] and she doesn't have any discomfort or symptoms (aka, she eats normally again, which seems to be likely based on her pneumonia recovery), then surgery probably isn't appropriate given her advanced age and her currently being underweight. We'd do an ultrasound regularly to check for tumor growth to make sure it is [3] and not [2], and given that we're dealing with a 12.5 year old dog, probably take no further action.
If instead we get [3] and she doesn't start eating enough, then we may have to look at surgery because that probably means the tumor is putting pressure on her stomach and making her feel full. Then we get all the same risks of surgery on an older dog plus some urgency since she doesn't have much weight left to lose. Another factor is that surgery is very expensive, has some risk given her age, and is by no means guaranteed to succeed. In short, it's more than a bit of a gamble.
So that's the health situation for Tulip. The good news is that she does not appear to be in significant pain most days, and has very nice painkillers when she is. I'm around all the time so she gets somewhat more attention. In one more week she'll be at her 12th gotcha day, and if she makes it to July 25 she'll be 13 years old. That's pretty good for an old lady dog. I'd like more.
In late February, we noticed that Tulip wasn't eating as much as she usually does and had in fact lost enough weight to be noticeably thinner. We weren't particularly concerned, given that in the previous month we had painted the house, which put Tulip in daycare for most of two weeks in addition to other "my house is being rearranged" stress. That was followed quickly by Chucha's sudden illness and passing, which was followed by another stint in daycare while we were in Orlando. In short, that's enough stress to make even the most even tempered dog a little wigged out. Since we needed to get her annual physical and updated shots anyway, we scheduled a checkup for early March.
A few days before that checkup, Tulip started hacking. The vet confirmed that she had kennel cough. Given that her kennel cough vaccine was about to expire, she'd just been at daycare for most of three weeks, and she's a little older anyway, that wasn't a huge surprise. Somewhat more surprising was that he also felt a large tumor in her abdomen. A needle biopsy and an ultrasound detected a single large tumor on her liver. Shit.
Now, given that Tulip is 12 years old and most knowledgeable observers think she's part boxer (a breed known for getting cancers), this wasn't a surprise either, especially she beat round one of cancer on her knee back in 2015. So we got pile of antibiotics and painkillers for the kennel cough and the name of a canine oncologist to talk to after the kennel cough was successfully treated.
That last about four days. On a Tuesday night M noticed that she was shaking near uncontrollably and having a lot of trouble breathing so we spent an evening at the emergency vet (our third overall visit in less than a month). You know how older humans sometimes get a flu that they can't shake off that turns into pneumonia? Dogs are exactly the same. Tulip was admitted for IV antibiotics and painkillers after the chest x-ray showed her kennel cough had turned into pneumonia.
Fortunately, the overnight treatment worked wonders. She got a new course of stronger antibiotics (two kinds!) which worked better. She showed significant improvement, but when we reached the end of that course she still had some symptoms, which were much like a human flu in that they involved a deep hacking cough and some sneezing. Our regular vet took another x-ray, which showed the pneumonia was much reduced but still present, so she got even more antibiotics and a steroid to reduce inflammation.
After two weeks on those, she seemed to feel much better. She was certainly eating better - during the height of her sickness we were spiking her food with chicken and salmon and treats for every meal and even then she didn't always eat it, but at this point she was back to four cups of fancy dog food a day, which is good because she was down 10% of her body weight and looked very skinny. However, after a few days off the antibiotics, a few symptoms came back, and we decided we weren't fucking around. Given her advanced age and symptoms and the high probability that liver cancer is messing with her immune system, our vet prescribed two more antibiotics today, which he believes should flatten what's left of the symptoms.
Assuming that all works and the kennel cough / pneumonia combo is finally taken care of, then we can turn to the liver cancer. There are broadly speaking three options in cases like this:
[1] The cancer has spread everywhere and nothing can be done.
[2] The cancer is in one place now but spreads fast. Surgery or chemo might keep it from spreading.
[3] The cancer is in one place now and is very slow moving. Depending on symptoms, doing nothing may be the appropriate treatment.
The canine oncologist reviewed all the lab work and said that as far as she can tell our regular vet was correct in that there is one big tumor on the liver that has not spread anywhere else. This is backed up by the blood work, two ultrasounds and both of her chest x-rays, and it seems to eliminate option [1], which is obviously very good news because if option [1] comes up palliative care is really the only viable option for a dog of any age, let alone an elderly old lady dog. The most likely diagnosis is option [3], with a slim chance of option [2].
If it does appear to be [3] and she doesn't have any discomfort or symptoms (aka, she eats normally again, which seems to be likely based on her pneumonia recovery), then surgery probably isn't appropriate given her advanced age and her currently being underweight. We'd do an ultrasound regularly to check for tumor growth to make sure it is [3] and not [2], and given that we're dealing with a 12.5 year old dog, probably take no further action.
If instead we get [3] and she doesn't start eating enough, then we may have to look at surgery because that probably means the tumor is putting pressure on her stomach and making her feel full. Then we get all the same risks of surgery on an older dog plus some urgency since she doesn't have much weight left to lose. Another factor is that surgery is very expensive, has some risk given her age, and is by no means guaranteed to succeed. In short, it's more than a bit of a gamble.
So that's the health situation for Tulip. The good news is that she does not appear to be in significant pain most days, and has very nice painkillers when she is. I'm around all the time so she gets somewhat more attention. In one more week she'll be at her 12th gotcha day, and if she makes it to July 25 she'll be 13 years old. That's pretty good for an old lady dog. I'd like more.