Wednesday, June 19, 2013

Losing Hope

Chad and I are so sad that the time has come to write this blog post, but we knew these events would be upon us sooner or later and we've been trying to prepare ourselves for many months. It's heartbreaking to think about, but the reality is that we are losing our tough, weird and absolutely precious girl Hope.

The crazy thing is, despite the fact that Hope has surpassed the average age of a Coonhound and  is also deaf and arthritic, she's still usually very happy and active. Her appetite is incredibly good--she's obsessed with food every waking moment of the day. Her favorite pastimes are searching the yard for mushrooms and perusing the floor for spills. This adorably sweet face stares up at me hoping for treats anytime I'm sitting in the kitchen--even when I'm not eating. She loves to go for walks, loves to meet new people and generally seems to love life. That's why it's so difficult to accept that she's once again battling cancer.

Hope's symptoms started just over a month ago, when we started noticing she was abnormally sneezy and snotty. She would occasionally wake us up in the middle of the night with some massive snoring, so we asked our vet about it at her annual checkup a few weeks later. He suggested that it might be allergies and prescribed more Benedryl, but he also tried to prepare us for the possibility that Hope might have a nasal tumor. Just a couple of weeks later, Hope starting having a massive amount of mucus come out of one nostril. I called the vet, who prescribed an antibiotic without even seeing her, but within a few days the mucus had become increasingly bloody. This was obviously quite messy and quite alarming, so last Monday we took her in for an x-ray and culture. When our vet saw Hope's sinus cavity on the x-ray, he was shocked at the amount of destruction of the soft tissue and cartilage on her leaky side. He thought the only options were a massive infection or cancer, and when the cytology came back with no bacterial or fungal infection, we knew cancer was the only option left.

Although we'd obviously had a great experience with Hope's surgeon in Overland Park, we weren't huge fans of the oncologist there, so today we took Hope to the College of Veterinary Medicine at K-State. We saw one of the oncology residents, Dr. Burr, who was absolutely wonderful. She was so amazingly patient with our plethora of questions and was so thorough in explaining everything. After leaving Hope there for a couple of hours for bloodwork and a biopsy of her lymph node, we found out from Dr. Burr that her tumor was not as expected. Instead of finding cells that confirmed a carcinoma in her sinuses, she actually found mast cells in the lymph node--meaning that she has a mast cell tumor (the same kind of tumors she's had in the past) somewhere that has metastasized.

I say a tumor "somewhere" and not in her sinuses because Dr. Burr indicated that a mast cell tumor in the nose is extremely rare--she's only seen one once in the 5 years she's been in oncology. So either Hope has a very rare sinonasal mast cell tumor, or she has a mast cell tumor somewhere else in her head and another cancerous tumor in her nose, which seems even more unlikely--at least to us. Dr. Burr wanted to do a CT scan and then biopsy the tumor(s) once they figured out exactly where they are, but we think it was more out of curiosity from a clinical standpoint, since Hope is such an unusual case. We declined that option--to us it didn't make a whole lot of sense. Ultimately, Hope has an inoperable tumor up her nose, and even though different drugs might work better on carcinoma, we know there's a mast cell tumor somewhere--and that should respond to a chemo/steroid combo.

So today our sweet little girl started chemo. We'll take her to Manhattan for chemo once a week for the next three weeks, and then every other week for four treatments after that. Thankfully, dogs don't have a lot of side effects from this chemo, and hopefully it will improve her quality of life as well as extend it. We just want our little weirdo to feel good as long as possible!

As I was looking back at some of the posts from 2007 when Hope had her first mast cell tumor, I realize even more how incredibly blessed we've been that this sweet and miraculous girl has been a part of our family. She's been enjoying life for six years since that first diagnosis--which seemed liked a death sentence at the time. She has provided us with thousands of hours of love and laughter, and we couldn't be more thankful for the time we've had with her and any additional time the chemo can provide.