It's now 2012. Remington died over 9 years ago, and mostly I remember the good times we had. But I can still remember the punch to the gut when his diagnosis and prognosis were given to me almost 10 years ago, not to mention the agony of wondering whether his treatment would help, and the grief at his loss. Those memories dim gradually, and it helps that I've had other wonderful dogs since then.
In the few years after he died, I received many emails from people who found these pages after their own dogs were diagnosed with or died from hemangiosarcoma, and found some comfort or some information here that helped them. Not long ago, another friend posted in her blog about splenic tumors in dogs, and the comments section of that blog has recently become a busy forum of people in similar circumstances today. I posted and commented for a while, but it is hard--there are so many dogs and there is so little that can be done.
Here are a few of my thoughts and comments from the last year while responding to many of those people and looking back through 10 years of my own research and reading and the experiences that too many of my friends and others have had with this awful cancer. [Unedited here--pasted mostly as is.]
- About anemia and rupturing nodules:
When my dog had hemangiosarcoma, the first symptom was anemia. At the time, we didn't suspect cancer, and it would just get better fairly quickly and then worse again, then better again for a while. The vet tested for various diseases that cause anemia and they all came back negative. That was starting at least 3 months before it got bad enough to do an ultrasound, which found the tumor. The reason for the anemia was that the tumor was periodically rupturing slightly and bleeding internally. A needle aspiration of the nodules might help them to tell whether they are malignant or not. You can ask your vet at what point they do that. Here's a link I just found: http://www.veterinaryradiology.net/153/splenic-nodules/
- Initial symptoms, doing ultrasounds on all dogs annually, blaming the vet for not knowing earlier:
Speaking with my experience with hemangiosarcoma in my dog and a lot of reading and talking to vets and other people after that about the illness: The symptoms are indeed typically that it ruptures, dog is suddenly very ill, huge tumor is discovered, dog usually dies or is put down within a few hours or weeks. Sometimes the first time it ruptures, the dog who is running and playing happily and apparently fine keels over and is gone. The thing is that there are many illnesses with dogs, many things that could go wrong, and even they're relatively more common in one breed than in another, that still might be one in a thousand dogs or even less often -- multiply by hundreds of things that could go wrong -- and you can't test for everything all the time. It would be hard on you, hard on the dog, hard on your wallet.
I asked my vet about having ultrasounds done on all my dogs every year to check for hemangiosarcoma.
- First: it's very expensive.
You would have to check with your vet on the cost of an ultrasound (sonogram) for the whole body cavity. You could check around for different prices. What I'm saying, based on what I've found and read (see the PDF noted above) that there's no way to know when to get one done to detect something. You could do it every six months from the age of 5 and still not happen to scan at the right time to find anything. Others may have different opinions as to whether it's even worth trying, but personally I don't think so. I'm not in the medical field at all, just another person who was punched in the gut to find that my seemingly healthy dog had a death sentence.
- Second: they're very quick-growing tumors, so maybe you do an ultrasound in January on their entire body cavity (which is a lot of searching for one random thing that might or might not be there), in April maybe the dog keels over from a ruptured tumor that appeared and grew within those 3 months and you'd still never have known.
He was fine again until he suddenly became very ill 2 months later. And that was the only symptom. Most people say that they never see symptoms until the very end. It's tempting to blame the vets for not knowing everything, but even if they told you all of the things that your dog could get or that the breed might get more often than other breeds, I'm sure that you'd not have come up with any way of making sure every week for the dog's entire life that he doesn't have the beginnings of something.
- First: it's very expensive.
- About whether vets or someone should have warned the owner of a Golden that hemangiosarcoma might happen to the dog:
This PDF document indicates that almost 19% of goldens die of hemangiosarcoma. It also confirms that the first symptoms are usually severe, that even twice yearly ultrasounds probably wouldn't help, that even with treatment, life expectancy would be a few weeks to a few months (with aggressive treatment, I got barely 4 months, and they weren't all great months).
This page indicates some of the many ailments and illnesses that might affect goldens more than other breeds or that might affect goldens, period. There are quite a few. But that's probably true of any breed. And don't believe that mutts avoid all those issuesmy hemangiosarcoma dog was a mixed breed.
I don't know whether I'm making things better or worseI'm trying to say that sometimes these things happen, and in fact there was probably nothing that you or the vets could have done differently at any time, except to prepare you that some dogs die younger than other dogs. :-( I'm sorry for your loss; my dog was only 9 and a half. Hurts when you really don't expect it. I now donate regularly to Morris Animal Foundation's research on canine cancers; too, too many friends have lost animals (most of them not goldens) to this disease.
- Letting the dog do things he loves, and wondering whether it's time to let go:
My AAD [agility title for Remington] dog never got a chance to get his third Masters Standard Q for his MAD, but he did get a chance to dig for gophers and stand and look at cows for hours on end, which I'm grateful for, too.
My Remington had periodic ruptures, but in between I was so lucky that he could do--at first--completely normal things--then, gradually, fewer and fewer. But he still loved to go exploring at the park, even when he was quite weak, and another thing he loved was staring at livestock, so at a friend's I just left him by the fence for a while and he watched the sheep for a couple of hours. At times, during a rupture when his blood count was so low and he was so weak and couldn't eat, I'd feel terrible for letting it go on, but then he'd eat again and I'd wait for a sign... the periods between, and his strength, got less and less and less, but I figured as long as he was eating and enjoying some parts of life, OK.
One night, he started having seizures. He seemed fine between them, but they terrified me--because I didn't know what was happening (not in the list of things that I was aware might happen) and really exhausted him, and finally decided that that was enough for his poor body to take. One often second-guesses oneself, I think, no matter what one does. Did I wait too long? Did I choose too soon? Was he more happy or more miserable? In the end, you do the best you canof course you do!and that's all that can be asked of anyone, and your dog loves you no matter what.
- About special diets and treatment:
It has been 9 years since I lost my dog to hemangiosarcoma, so all the hours and hours that I spent researching on the web is probably out of date. I also encountered the cancer diet thing. My recollection from everything I read then was that there has been no rigorous study of the effectiveness of much of any kind of treatment. Of course part of the problem is that many of the dogs die or are put to sleep right at the time of the discovery, and the cancer can be so aggressive that they're not around very long anyway, which makes it hard to do studies on treatments. My impression is that there are a few anecdotal stories about someone who got lucky and whose dog survived and they attribute it to one particular aspect of something that they did, but that in fact there's no evidence that that one thing was what worked or whether it was a combination of factors or they just got lucky and their dog would've survived anyway. Believe me, that doesn't make it any easier to decide what to do.
I can only speak again from my own experience: My dog's tumor appeared on his heart; got lucky that it didn't kill him outright. Did surgery to put a drainage hole in his pericardium so that any bleeding out wouldn't put excessive pressure on his heart, and we did chemo. Also changed his diet to a canned cancer diet, but didn't try the home-grown cancer diet that I've seen on the web. The tumor was inoperable. He survived about 4 months, not all of it in great health but some of it, yes.
Another friend discovered a tumor on her dog's spleen at the same time. They did a splenectomy and chemo. And her dog also survived about 4 months. She did change her dog's diet some but I don't know the exact details.
- On second-guessing yourself and your vets:
Just as in humans, different dogs' bodies react differently to the exact same thing. it's a tragedy of medicine that, although so much is known and so much can be done, there's never a way to know 100% what will happen in any specific situation. All any of us can do (and that includes the vets and those of us with ailing dogs) is to make the best decisions that we can, given the information that we have at the time. There is no crystal ball to see the future or to see the what-ifs and certainly not the whys--how I wish there were!
It's so easy to find oneself in a place of saying, "if only I hadn't done ___, then the outcome would've been different," but there's no way for one to know that, really, maybe if one *hadn't* done X, then the results would've been so bad that one might've been saying, "if only I *had* done ___, then things would be different." I think that everyone does that to one degree or another.
- About grief and guilt and pain:
Of course neither of you will ever be the same. Every special thing that comes into our lives changes us, and when they leave, it changes us again. Everyone grieves in his or her own way, and it just takes as long as it takes. I live a normal, happy life. But each of my dogs that has left me has put me through a period of agonized grieving that I felt, every time, would never end. That doesn't mean the pain isn't thereif I sit and remember the time and the place and remember the *memories of the emotions*, I can put myself right back into tears. But I can also put it aside again and go on with my new dogs, and love them as strongly, but differently, than I loved the others. (After my first dog died, it was 2 years before I could even conceive of having another dog in my life.)
You might find this link to be informative--it talks about the seven stages of grieving, but also says, "it is important to interpret the stages loosely, and expect much individual variation. There is no neat progression from one stage to the next. In reality, there is much looping back, or stages can hit at the same time, or occur out of order. So why bother with stage models at all? Because they are a good general guide of what to expect." I hope that what it says helps.
You can't make yourself be happy again--grief will take as much time as it needs. I predict that it will flow and ebb and someday it will mostly be quiet and most of your memories will be happy. But for me it takes a long time after each dog. I'm fortunate in having enough interests to have kept me busy and focusing on something else, but in the quiet times, that's when it always hit the worst. I also, like lots of people, feel like I'm seeing or hearing my dog in the house still, bringing me comfort that his or her memory is still here, still happy.
And here's a link that I have also found helpful in understanding and somewhat dealing with loss and guilt related to the death of a loved pet.