The Journey of Ellie the Great Pyrenees Mix – navigating life after being diagnosed with osteosarcoma

Dear Ellie, it’s been a month…

It feels like it was both just yesterday and a lifetime ago since I had to say “see yah later”. I have been thinking about writing this for a while, even tried starting it a couple times. My intention was for it to be a little more light hearted, but the moment I typed the title tears started streaming so I guess we’ll see how it goes…

I very purposefully wanted to keep it light hearted, because you never took life seriously let alone too seriously.

The first couple weeks it was just pure grief, I don’t think there is any reason to tell you about any of that- you get it. After that though, the things that have brought tears to my eyes have often times made me laugh at the same time. for example, dropping food on the floor. The first time it happened I just stood there and stared at it, my mind couldn’t comprehend that nothing was coming around to hoover it up. After that, the next thing I noticed was just how much food I freaking drop on the floor! Why did I even need to feed you actual dog food, girl?

Speaking of floors, for all the food that drops on them you’d think they’d be gross, but they’ve never been cleaner. I was not in denial about how much you shed, but you’ve been gone a month, how is there STILL fur when I vacuum? That’s not what makes me tear up though, what does is I no longer have to clean out the drain of dog hair right away when I shower. I still do it out of habit sometimes and you lounging in there pops in my head, it’s still the coolest place in the house on hot days.

I’ve kept up with our morning walks, and am bummed I never got you over to the new natural area that is only a few blocks away, I also found a new route that goes into a neighborhood to the North and then around the pond, you would have loved it. I will say the walks are different now, I don’t have to stop every 6 feet for you to get caught up with the most recent smell news. Nor do I have to survive your side eye whenever I stop to take pictures of bees in flowers, hehe.

Meeka has missed you for sure, she is begrudgingly putting up with so much more attention than she prefers, but we have found our balance. The nights she stays in she has found a spot near me to sleep where I also can’t reach to pet her… I don’t think that’s a coincidence, haha.

I’ve felt your absence on the farm too. Yes, you were originally supposed to be more of a livestock guardian, but that was definitely your secondary role. You had a huge impact though, and it’s continuing to show just how much now. You were never really a barker, so whenever you did I always took notice and we prevented a lot of issues. I think just your scent kept many racoons/foxes at bay as well. My belief of this has only been reinforced since you’ve been gone. A couple weeks ago we had our first ever dog attack here in the almost 8 years I’ve been here. A dog squeezed through the the gate to which I was completely oblivious even though my door and window was open and got to Valentino, our resident tom turkey and glorified mascot. It was no ones fault. The dog was being a dog, the owner took full accountability- his 3 year old opened the door and the dog got out, it was a total accident. and yet Valentino is dead and it’s agonizingly unfair. The other part that truly kills me is I am 100% sure that if you had still been here it would have been completely avoided. You would have alerted immediately and ran out there, with me on your heels and we would have taken the dog back home without incident (she lives just next door and has always been a sweet well behaved dog who we’ve never had issues with).

It made me consider if I should get another dog. But I don’t want another dog, I have been more social in the past 2 weeks than the past year because there hasn’t been any living beings depending on me. I almost booked tickets to Chicago to catch an impromptu concert next week mostly just because I could. I don’t want another dog, I just want you back. You were worth every missed engagement and worth complicating every travel plan. I’m sure I will get another one in the future, but there is no replacing you. If I did, as hard a I would try not to I would compare everything- you would be the baseline, and that’s just not fair to any other dog. So that needs to pass, or some serendipity needs to happen where a ‘it’s meant to be’ moment occurs so that that any new relationship has it’s own story a not just riding your coat tails. For now I am still simply missing you.

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Ellie’s Cats

I’ve gotten so many sweet caring bittersweet comments in wake of Ellie’s passing. A humorous side of this is people have also noticed just how many videos/photos I have of Ellie with all her cats and the unique relationship she had with all of them. I wanted to take a moment to really highlight this as it’s something that really made Ellie unique and it often times it was as hilarious as it was sweet. So without further ado I present to you Ellie’s Cats.

Kima

I got Kima as a 2 month old kitten in the beginning of December 2015 and Ellie as a 2 month old puppy in March of 2016 so Kima is only slightly older and they grew up together. my older dog, Codee, was already 12 when I got them and even though she did play, she was definitely not as “receptive” to Ellie as Kima was. It was so much fun watching these twos relationship grow. Most of the videos/photos I have are basically Kima completely bullying Ellie but in reality they had a very beautiful mutual relationship and that was just their style, Kima was little even by normal cat standards so compared to Ellie she was teeny, but she made up for it in craziness. She was easily the coolest cat I’ve ever owned (yep I’m totally playing favorites sorry Channing and Meeka). Added bonus she is the only animal who actually played Fetch with me (Codee and Ellie were really enthusiastic about running after things and then playing no take backs though)

Channing and Meeka

I got Channing and Meeka as a brother and sister (yep swear they are full brother and sister). Their personalities were as different as their appearances. Channing was very outgoing and bossy- it was his world and we were there to shower him with love and attention. In his defense he is arguably the most handsome cat I’ve ever seen so the ego was probably inevitable.

Meeka on the other hand slinks around always watching, but rarely participating. She never really liked to be in my lap unless Channing also was there, but she’s always close by. Even when I would take Ellie on walks Meeka would often follow well behind, and if I turned around she’d take off only to pop up a little while a little.

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If you want to make God laugh….

…Tell them your plans.

I really hate how true that phrase is. I never learn either, I will always plan everything and be amazed when it quite often completely falls apart. My plan with Ellie is no different. it’s shattered really, and I’m so angry and confused, and utterly heartbroken I can’t really process it all yet.

So to get you caught up. Sunday morning everything was normal, but Ellie didn’t want to go for a walk and when we came back in she yelped pretty bad, and then yelped again as she was laying down. I checked all over her, but she jumped right back up and ate her breakfast happily. I went ahead and gave her gabapentin and carprofen to be on the safe side, but she seemed fine after that. That evening she was bopping around outside like normal. Monday morning was a different story. when I got up, I gave her her normal belly rubs, she happily lounged on her back making sure I got both sides and got up with no issues. But when she went outside she yelped…and then didn’t stop. She couldn’t stand, she couldn’t sit, she couldn’t lay down, everything hurt. I called the vet and was free to bring her in right away but getting her into my SUV was a huge issue. She couldn’t stand up without yelping let alone walk, if I moved her at all she cried out- I felt so incredibly helpless. I ended up backing my SUV as far back as I could, so we only had to move her about 10 ft to get her in. While I was backing the SUV she had moved closer and probably with the last bit of energy she had scrambled up the ramp with me pushing/supporting and she was in. At the vet they were able to give her IV pain killers which at least took the edge off whatever was causing her pain, and sedated her heavily to do X rays. There was nothing to explain her pain. Other than lung mets (which is the most common with 80% of cases) it’s unfortunately pretty common for osteosarcoma to move into the spine and not be obvious on x ray, so that was the assumption made. Regardless of if it was that or not, it didn’t really matter, even completely loaded on painkillers she was at the very least uncomfortable. I was given the option to take her home and see how she did over the next couple days, but I could not in good conscious put her through even the car ride home let alone days of obvious pain. So Monday afternoon we said our goodbyes. My literal only solace is I’m so incredibly grateful she’s not in anymore pain. Apart from that I am Angry and Heartbroken. I went from planning this epic trip to San Diego for us to hopefully steal a few more months and make sure I gave this pup everything she deserved to saying goodbye in less than 24 hours.

It wasn’t supposed to go like this. She was supposed to be the miracle, the one who beats the odds. But then we adapted when her cancer spread, there was no miracle, but it wasn’t going to spread more- the vet said it was stable.. that means it shouldn’t spread (oh the lies we tell ourselves) she would have months of pain free time and we were living it up and not wasting a moment. I know I shouldn’t have, but I would silently pray for her to see her 8th birthday (Jan 25) it didn’t seem too outlandish of a hope it would have been 10 months from when she was first diagnosed, but it wasn’t meant to be. Instead of being the miracle we have now been destined to be the cautionary tale. Even if you do everything- amputation, chemo, rehabilitation, catching it before it spreads, having healthy bloodwork, having zero past health issues- that is no guarantee that you will get any extra time. 4 months, that’s all we were given, and 1.5 months of it were spent recovering- how is that fair? Simply put, it’s not and that’s life in all the chaos of it. Through the unfairness I have to search for any scrap of good to keep from losing my mind or just falling into a great depression feeling like I utterly failed the most important being in my world.

If I had known what I know now would I have changed anything? no chemo obviously, but apart from that it was either amputation or getting put down because she was in pain then. Would I have welcomed only 4 months where part of that was spent in pain, I honestly don’t know. Probably not. Do I regret getting it done? No. It was a risk, I wasn’t lied to about anything, and the hope/chance of having more time was worth it.

It’s only been a day so this is obviously the very raw emotions of things. My brain has barely comprehended that she’s no longer here, and my body is clueless. Every time I stand up I listen for her to stand as well and follow me as she always did. My eyes search for her multiple times to make sure I haven’t left the gate open and have to grab her from wandering too far. It feels foreign to open the fridge door all the way versus only about 12 inches because one of her favorite spots to watch me cook was there, and she had no inclination to move. I heard a dog bark and it sounded just like her and I wondered who was here. I realized I hadn’t fed her this evening before I realized I didn’t have to. I went on our morning walk and my hand felt foreign not having a leash in it. It’s just so different, I’ve never been in this house without a dog- it honestly doesn’t really feel like home right now.

I have found two comforts throughout today. Going through every single photo/video I have of her and compiling a little memorial to her. Reliving so many memories, seeing her so healthy and joyful, reminding myself that though it was much too short she lived a full life. It’s been on repeat since I finished it.

The second has been Andrea Gibson. She is a poet who also has ovarian cancer. I found her long before any of this, and even though I never really “got” poetry hers resonated with me on a different level. there have been 2 poems specifically that have really touched my heart and I’m trying to absorb more and more as I try to let go of the anger and be vulnerable enough to accept the awe and the gratitude. In “I stopped waiting for Awe to find me” she says:

“I know how difficult it is for anyone to believe the light of my joy has not been dimmed by cancer. The only way I can explain it is to say, I stopped waiting for awe to find me. Now I find it.

By the end of our lives, if we’ve not said “WOW” thirty million times––we don’t get into heaven. What purpose could I possibly have that’s greater than building my goosebump collection? Last night I lifted my head to the Northern Lights and they flew six thousand miles to see me. I’m on their bucket list…

People think I’ve gone mad because I’m not mad at my life. I haven’t lost my mind. I know exactly where I left it. I’ve simply learned to think with my gratitude, pray with my pain, love with everything I could ever and never lose.”

The other one I found just today as I was searching for the above. It’s called “A Letter to My Dog, Exploring the Human Condition” It’s one of those where you laugh and then cry only to laugh again while magically having your perception adjusted without realizing it. I hope you give a listen, and then choose to listen to it again 🙂

I will eventually find Andrea level gratitude and work on my goose bump collection, but not tonight. Tonight is still for All things Ellie as my body slowly realizes she’s not on this plane anymore. Rest in Peace EllBell.

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Updates

I am long overdue for an update on Ellie. I ended up going into a bit of a depression, the past couple months have been crazy busy/stressful. I gritted my teeth and got through it, but when I had a chance to breathe I ended up shutting down. I don’t know if anyone can relate, but I am in full blown “Decision Fatigue”. Even simple decisions lately, have been absolutely overwhelming to make let alone the big ones. In my last post I was very clear in my decisions, but now I don’t know, haha.

Ellie helping me on building out the cargo trailer- so helpful!

Lets start with the good. We got updated X rays of Ellie’s lungs back on June 21st, and there is no sign of new nodules or new growth on the existing nodules!! That’s so freaking exciting and I’m over the moon about it. She is completely back to her old ways- when she gets excited she does the cutest little hoppity hop and she’s started getting zoomies almost daily. She still doesn’t have the greatest endurance, but as long as we have the stroller we can go however far we want and we have figured out a pretty decent communication on when she needs/wants to get in. Unfortunately, since I feel the need to bring the stroller we haven’t been able to do some of our most common hikes, which does bum me out specially with it being summer- we are usually up in the mountains a lot to escape the heat and enjoy the nature, but we are grateful for what we have and make do just fine (I am so freaking spoiled on all the outdoor areas we have, and fully realize it).

The not so good, but resolved. When we went in for X rays I was actually really really worried, because Ellie had been intermittently throwing up about once a day for nearly a week. She also had what I thought was swollen lips/muzzle, which turned out to be that the hair there fell out/rubbed off over the course of only a day (see pictures below). With everything I obviously immediately jumped to the worst case scenario (as did the vet, haha), there was no sign of blockage in her abdomen x rays so she was worried that Ellie may have a mass in her stomach. She didn’t know what to think of the what we thought was swelling, we wondered if she might have gotten stung/bit by something etc, but gave me a prescription for prednisone since it wasn’t “going down” even after 6 days. We were going to do an ultrasound of her stomach, but I held off, because the vomiting seemed to be happening at specific times either when she was really excited or right after eating, drank a bunch of water. I ended up getting a special water bowl with a floater so it would slow down her drinking (added bonus it stops her from spilling 2/3 of it on the floor), she hasn’t had an episode since getting that, so big sigh of relief. Still no idea what the cause of the losing hair on her muzzle, though, any guesses? It has since regrown back.

normal muzzle

no hair- looks swollen, but actually isn’t.

Due to there being zero change in her lung nodules, I’m really conflicted on moving forward with the MIMIC trial surgery. I should have emailed Dr. Thomsen right when I got the X rays and asked his opinion, but due to my depression I have avoided it until literally this morning. I hope he agrees with me and says it makes sense to just wait and see. Do X rays every 3 months until we start to see a change. I’m worried that removing the existing ones will just cause new ones either in a different (more painful) location or in the lungs, but be more aggressive. My mind is like why rock the boat? With that said, it may be a naïve point of view, so I did finally email him with the X rays to see what he thinks, I should probably email Ellie’s oncologist as well, but I’m pretty sure she would agree with me, as that was her concern with the surgery originally. I know Dr. Thomsen has commented that he usually sees dogs after they’ve exhausted everything else and are pretty advanced which hurts their chances, so I don’t want that, but we’ll see what he says.

Regardless, we have been enjoying our summer. Ellie has been swimming twice!! She’s a total Rockstar, and it’s been a lot of fun seeing her do everything she loves to do. We recently had our 3rd annual cardboard regatta (a hilarious cardboard boat race), I brought Ellie and she received so much love and attention, and met a bunch of new dogs who she actually played with (usually she ignores dogs after initial sniffs)!! I made a really silly/stupid “trailer” for the race that I just have to share:

We were lucky enough to be the winning bid for one of the Tripawd Dog paintings! I’m absolutely in love with it, and it has found it’s perfect home on my gallery wall. It adds special meaning knowing this was Sapphire’s last painting and I assured Sapphire’s parents that it would be cherished always.<3<3<3<3

That’s that update! I hope everyone is having a fantastic summer and I will post again soon! Till next time <3 <3

Ellie enjoying the view at the 3rd Annual Cardboard Regatta

Next Steps

(please skip to after the picture to just read about the next steps)It will be 2 weeks tomorrow since we found out Ellie’s osteosarcoma had spread to her lungs. the 1st few days were pretty much pure emotion of sadness, anger, disbelief, overwhelmed, hopelessness. I think that’s important to state, because everyone is very quick to say “There are more options!” “It’s not over yet!” and it would be easy to just put a blind eye and soldier on with positivity slapped on my grief. I’m not saying go pure doom and gloom, but as someone who shoved all emotions down for years because I thought that most emotions were bad- it’s simply not sustainable. Those pent up feelings will find a way out and if they are forced down it will probably not be the most constructive outlet.

With that- the situation really sucks. If you go by the numbers a dog diagnosed with osteosarcoma has a median survival rate of about a year with treatment. A dog with lung metastasis has a median survival rate of about 6 months with treatment (of Palladia/Losartan). So statistically it really sucks! I knew I wouldn’t be able to make any decisions until I let myself really feel the reality of the situation- all of it. Not just the negative side, not just the beating the odds side- all of it. The overwhelming feeling I had was the unfairness of it all. I was mad that I had put in all this effort, money, followed all the advice only to be in this situation so soon. I felt I was entitled to more time. These emotions were extremely selfish and came from a really arrogant space- I won’t lie, but they were there and I let myself feel them without judgment or placation. Accepting that, and letting it out allowed space for everything else to breathe. I wouldn’t say I’m at peace with it, but I can see clearly again. Enough to reprioritize, refocus on what’s truly important, and decide the next course of action.

Before choosing what to do, I re-evaluated what my goals were. Before it was semi-vague- for Ellie to have a good quality of life, and I hoped she would make it a year. That goal was very conflicting, I knew in my head I always say quality over quantity, but I still had this quantitative goal. so in re-evaluating I looked more at what am I willing to potentially put Ellie through. I looked at the risks of treatments, common side effects, possible outcomes, and recovery periods. I found that I have 4 options:

Palladia/Losartan- an oral chemotherapy given on different days that can shrink tumors in 50% of patients. Common side effects are most commonly lethargy, GI upset which can cause lack of appetite, vomiting, diarrhea. Some dogs handle it pretty well, some don’t, but they can adjust the timing of the medication and supplement with prednisone or cerenia to help with side effects. It would cost ~300-700/month for vet visits (depending on if they took xrays or not).
Palladia/Losartan + study drug clinical trial- There is a clinical trial at CSU for dogs with lung metasasis the Ellie would qualify for that is the same Palladia/Losartan protocol plus an additional drug that I can’t remember the name of. It would have been very similar to the previous trial Ellie was in with a little less intense check-ins, but we’d need to go in every 2 weeks or so for blood work. Ellie would also have to get a bronchial lavage twice throughout the trial. So all the same common side effects as well as a couple appointments where she would need to be put under general anesthesia for the lavage, but the lavage itself there was really no recovery period from. Costs would be covered by the study.
Minimally Invasive Metastasectomy in Canines (MIMIC) clinical trial- There is a whole tripawds podcast dedicated to this, but this trial is where enrolled dogs have a minimally invasive surgery to physically remove the diseased lung. because it’s minimally invasive most dogs get to head home in 24 hours after surgery (their goal is to eventually have this be an outpatient surgery). recovery is pretty minimal only needing to keep dogs quiet so they don’t pull any of their stitches, very low pain. Ellie would need to have a CT scan to be enrolled in the study, and then 2 more one at 2 months and 6 months post-op Some patients will have chemo after surgery, some will not. the study covers the cost of the ct scans and up to $5000 of the surgery, usually the owner will pay around $4,000-$5000.
Do nothing- Ellie’s nodules are very small, at this time she still has 99.9% lung capacity and that can go down to as much as 65% before you start seeing symptoms. We could get bloodwork/X-rays every few months to track the progress and go from there.

There’s pros and cons to all of them so it really comes down to my goals on how best to proceed. my biggest needs were to keep any discomfort to an absolute minimum, that took out options 1 and 2. I know the side effects are common and can be treated, but seeing how Ellie has bounced back more and more as we haven’t been on any chemotherapy reinforces my decision that even though she wasn’t throwing up and would eat her normal kibble (sometimes had to be convinced with added broth) she still didn’t feel 100% on it…and without those signs I don’t know how bad she might be feeling. It was not worth having her on this protocol for the rest of her life in which is will make her feel not so great to buy us a few more months…if that. So that left options 3 and 4. I’m not ready for 4, and I don’t think Ellie is either. So that leaves 3- with a caveat. I am going to get new xrays done here in a couple weeks to see how things have progressed. I am still really worried that Ellie got the super short straw and has an extremely aggressive form of osteosarcoma, so if we get new xrays and the number of nodules has doubled then the surgery probably won’t be very effective and thus not worth doing, but if they aren’t new ones we will move forward to do the surgery and not do any chemotherapy afterward. Ellie will have 3 kinda drugged out crappy days and then be done and whatever the world decides to give we will take joyously and not have to schedule vet visits or worry about side effects and just go live life.

So that’s where we are at!