The end

Today was Sam's last day. Although the Tramadol bought him a few good weeks, he was no longer getting good pain control even on double doses, so I chose to end his life this morning.

There's no good time to make this sort of decision. Sam seemed to enjoy cuddling with both Tim and I last night, but he'd gone from being eager to go for a walk to being willing only to walk a house or a two down the street, limping badly and panting on the return trip. We could have waited longer (days? weeks? a month?), and he would have had some more good times, but it seemed like the bad times were starting to dominate, and it seemed selfish to keep him alive but in pain while we tried to atone for some of the "demotion to dog" that all of our dogs have experienced over the past couple years.

So Tim took Dalton out for a tour of the coffee shop, mall, and pet store, while I made Sam (and TY) scrambled eggs (a favorite) for breakfast, and then took him for his last trip to the vet.

We scattered Modi's ashes in the back yard last week. I expect we'll do the same for Sammy.

I told Dalton last night that Sammy's leg was hurt (which he knew) and that Sammy was going to die. D hasn't asked about Sam at all today. I'm not sure if he hasn't noticed (possible, Sam never came upstairs), or if we're all just avoiding the subject.

It occurs to me as I type this that I haven't said much about Sam's life. That'll have to be the subject of a later post.

A Sam update

We took Sam in to see our regular vet today. Dr. Jones is an older vet and generally pretty no-nonsense. We've valued his willingness to whip out the staple gun after to patch up injuries from various dog shenanigans in the past, where other vets have insisted on anesthesia and an overnight stay. He also really obviously likes dogs, which should be a no-brainer in a vet, but yet doesn't always seem to be. We'd tried another vet last week (for what ended up being Sam's osteosarcoma diagnosis) mostly because he's been scaling back his hours and we don't like the other vets in his practice nearly as much as we like him.

Faced with the osteosarcoma diagnosis and trying to figure out what to do, we decided we wanted to go back to Dr. Jones for his opinion, and I'm glad we did.

Dr. Jones was far less in favor of doing an amputation or chemo. His definition of dog quality of life, which he shared today, is: Able to get up and move around, able to eat and drink, able to use the bathroom outside. Yes, he said, young dogs with three good legs do fine after amputation, but currently Sam is able to do all three things, and if he has the amputation, that might or might not be true, and the potential gain in survival time from the amputation is not very large, and there's some definite recovery time.

So the current plan for Sam is to continue to medicate for pain and to take things as they come. Dr. Jones certainly didn't think it was time to euthanize Sam now, and his confidence that we'd know when it was time made me feel better about the whole thing.

Sam is currently taking Tramadol for pain. He seems to feel pretty good. I won't say he's 100% pain free, but he doesn't seem like he's actually worse than he was six months ago, before the tumor and before the Tramadol. He pulls on the leash, spins in circles to go out, carries toys around the house, and occasionally trots around in the yard (if Tim carries him down the stairs or I walk him around from the front), rolls over for more tummy pets if the human sitting next to him gets distracted, and jockeys for position under the high chair when scrambled eggs are falling from the sky. Perfect? No. But good enough. He may not live to next summer, but at the moment, he seems to still be enjoying being a dog in our house, particularly now that his people are lavishing extra attention on him.

This is not a good year to be a dog in our house

Tim took Sam to the vet today. Sam's been limping worse than usual for a week or so, and his wrist was swollen. I figured it was his arthritis acting up, but the vet's pretty sure it is actually bone cancer. They don't see metatheses on the lung x-ray, but 90% of bone cancers in dogs have already micrometathesized upon diagnosis.

So we're going to get to make some fun decisions about treatment.

We can do nothing about the tumor and put him down in the very near future, since the vet doesn't think she can adequately control his pain without amputating.

We can have the leg amputated, which will resolve the leg pain and may get Sam four good months (average, damn statistics), but won't do anything for the metatheses that are likely already present and will ultimately kill him or lead us to having him euthanized. I have some serious doubts about whether or not he can manage to get around ok on his three other legs, given that he's got some arthritis in what would be the remaining foot. I'm trying to remember as I type this if it is the "good" front foot or the "bad" one that he'd have left. He's babied one leg, I think the one without cancer, for several years now, so he'd have to carry his full front weight on one gimpy front leg if we go this route. What if we put him through the amputation, only to end up deciding that his quality of life is too poor?

We can amputate and do chemo and have a life expectancy of about a year, but with some number of days spent at the vet receiving chemo, and some number of days feeling sick from chemo. Sam is spazzy when we've kenneled him. He's the reason we've always hired pet sitters, ever since the kennel I used to take TY to (when he was an only dog) told me not to bring Sam back. I'm having a hard time picturing him being happy confined at the vet for a whole day and night every few days. We'd also have a hard time schlepping him back and forth to the vet, given the realities of jobs with late hours and a car that doesn't easily hold a toddler and a dog simultaneously. Sam has previously demonstrated just how much damage a dog with intestinal distress can do to a house.

I'm reading this and thinking how shallow it sounds to say chemo's too expensive or I can't be bothered to do the vet appointments and deal with (and clean up after) a neurotic, arthritic dog trying to figure out how to walk on three legs, but regardless of what we do, we're looking at a life expectancy of a year at most.

*sigh*-