Prologue: Part Two

Two days later, Stella, Jim, and I, still exhausted and a little manky from the drive, all crowded into the examination room at Village Vets of Decatur.  Dr. Stacy Stacy (yes, a woman named Stacy married a man whose last name is Stacy) examined Stella and let us know that she didn't feel anything unusual in Stella's anal glands. It was a false alarm!  I burst into tears and Jim hugged our yellow girl (who squirmed and protested).  But when I pointed out that her sebaceous cyst seemed a little red and crusty, Dr. Stacy immediately said, "I don't like the look of that."  She carefully did a fine needle aspirate biopsy, just a teeny prick of the bump, and took it back to do a stain.  We waited, confused by the ricochet of concern, relief, and concern.  Stella had had this bump for more than two years, probably closer to three.  The first vet we saw back in 2009 said it was a sebaceous cyst, nothing to be concerned about.

When Dr. Stacy returned, she said the stain showed signs of mast cells, a strange presentation (this would come to be a recurring theme), but certainly mast cells and that it was, in all likelihood, a malignancy.  We wouldn't know for sure till it was removed and it needed to be removed as soon as possible.  I had been reading up on adenocarcinoma compulsively for 72 hours and in a split second, I felt my perspective shift like a twist on a rubik's cube.  Not the dreaded adenocarcinoma, that's good, but now we were dealing with something called a mast cell tumor.  Either way, Stella had cancer.

If you're reading this now, chances are your sweet dog has been diagnosed with a mastocytoma or mast cell disease.  Like me, you probably went to the intertubes and discovered reems of vet info on the disease, tons of pharmaceutical promotional materials, hundreds of frightening medical studies, a handful of canine cancer support messageboards (the dearth of which still surprises me), and just a few personal blogs charting one's experience with the course of this cancer.  Mast Cell Disease is a frustrating diagnosis because it truly is the chameleon of cancers.  According to DVM360, mastocytoma is the most common dermal malignancy in dogs, but it can look and act radically different from dog to dog.  One dog can live for years after simple surgery, yet another dog will immediately develop another tumor and perish rapidly.  Sometimes dogs grow only small dermal tumors that never do any damage at all and can be removed without incident like an on-going game of whack a mole.  Other times, rampant mast cells invade lymph nodes, metastasize into the spleen, and wreck havoc on a dog's vital organs.  In some dogs a mast cell tumor can sit quietly for years.  In others, a single tumor degranulates out of the blue causing irreparable shock.

The treatment choices are many, from fairly inexpensive to budget busting (we joke that we should keep our credit card in a holster) to downright lifestyle changing (I discovered I really don't care about having cable tv or eating out as long as Stella is ill).  There are specialists that can be seen: internists, surgeons, oncologists, radiologists, nutritionalists, naturopaths, acupuncturists, palliative care vets and, sadly, the doc who may specialize in euthanasia (if you want to have those last moments at home).  Sometimes this can involve traveling to other hospitals, or even a far off teaching hospital (many states have a university vet school where speciality clinics are used as teaching facilities).

There are choices to be made that are heart wrenching, but necessary, and everyone has to make them based on very personal criteria.  How much money can I spend on my dog's treatment?  How much treatment do I want to pursue?  When is enough, in the end, enough?  Should I home cook for my dog?  How much time can I take off from work to make the 200+ mile round trip drive to the vet teaching hospital for diagnosis and treatment?  Can I bear to watch my beloved dog endure short term discomfort for long term survival? How much does the three week course of daily radiation cost?!? If I choose one chemotherapy over another, will I decrease the chances of her surviving? How much diarrhea can I handle cleaning up off the rug?  Am I making the right choices?  Jesus, are my choices making this worse for her?  Is today her last day?

Five years after first feeling that curious little bump, for the benefit of Stella's wellbeing and much to the potential annoyance of every vet and specialist we cross paths with in the Bay Area, I have learned to be persistent, to take notes and have my questions ready.  I have learned to not just passively take all the information given in the hope that I am being a compliant and easy going doggie mommy, but to engage my vets and use up every second of my scheduled time to be sure my concerns are addressed.  When your loved one's health (or your own, for that matter) is critical, no question is to stupid to ask and understanding the ramification of every surgery, drug or procedure can demystify the entire, overwhelming process.  No one knows Stella better than Jim or me.  No one will fight harder for her than we will.

Today, in the end of May 2014, we are still neck deep in the weeds.  Early crises (I'll get to those later) have, thankfully, passed but Stella's fight continues and she has already outlived her initial prognosis by a few months.  Some days my anxiety over her illness threatens to demolish the slender peace I have grown from uncomfortable seed.  Some days a whole new cancer related health issue pops that has to be addressed with swift determination (I am still not sure how best to feed her in a way that will diminish her gastric discomfort).  Other days, Stella seems just like Stella.  She may be a little slower, more inclined to nap, but she still positively lives to eat, pulls the entire walk to Blake Garden, obsessively checks each and every gopher hole and freshly turned up dirt pile, chases bad squirrels, barks at the mule deer, and fills our life with so much joy.  Today, at the very least, Stella is happy, hungry, and, most importantly, comfortable.

So, I'm here on the interweb to document what we've experienced, what are still experiencing, in the hope that if you are going through this cancer fight, you know there is someone out there who has experienced something similar and that you are not alone.