Tues., Dec. 20, 2011 - Bleeding from the "good" side of his nose and another CT scan

This will be a hard update for me to write.  So much has happened in a little over a week, and Hardee has suffered some trauma that is unforgivable, and I have no one to blame but myself.  You will judge me harshly, but I am writing this all down in hopes it will help someone else like me who has never experienced anything like this before.  I hope no dog has to endure what Hardee did on Monday.  And the long story begins.

Over a week ago, Hardee started bleeding from the nose.  What worried me about this bleed was it was unprovoked.  There is usually a catalyst that sets off a bleed (a biopsy, vet treatments that caused his blood pressure to rise, chasing his ball too much, etc.), but there was none this time.  HH was just sitting on the kitchen floor one morning with blood dripping out of his nose onto the floor.  When we thought the bleeding was under control, HH would sneeze again, blowing out a clot, and we'd start all over again.  Something else to worry about was the fact that the blood was coming from the "good" side of his nose.  We have never had blood from that side of his nose before, though just recently we got a little mucoid drainage from there.  Within hours, the blood was coming from both sides of his nose. 

By Thursday afternoon, the bleeding had stopped, or so we thought.  There was only old blood when he sneezed.  Hardee and I went ahead to an interview we had scheduled at a hospice facility to start up his therapy dog work again that we had stopped sometime during his cancer treatments.  All went well with no blood and everybody loved him, but he started reverse sneezing quite a bit.  He got into a pattern of reverse sneezing that he couldn't stop when we were leaving the facility.  Reverse sneezing is a bad sign and one that had disappeared for a year after we did radiation.  I was getting more scared.

Since the bleeding had stopped for a while, we thought it safe to head for our 3 day agility trial that we had scheduled in SoCal.  Instead of leaving Thursday afternoon for the trial, we didn't leave until very, very early Friday morning to make sure things were okay.  Hardee ran great in both of his runs and got a double qualifying score with great times.  After we got checked into the hotel, Hardee's nose started bleeding again, off and on, mainly when he sneezed, and mostly it was old blood.  Good thing we packed our hydrogen peroxide and carpet cleaner sprays.  We also packed flannel sheets to cover the floor carpeting in case of bleeding, and we have always packed flannel sheets that we cover the hotel bedding with. (For those on facebook, think about the post this afternoon about things to worry about from emails this year.  Those who know me well will know of my germ phobia and how hotel rooms freak me out.  The first thing off the bed is the bedspread, then the blanket is folded down with the sheet over it so I don't have to touch it, then everything is covered with our thick flannel sheets.)  Who knew that my germ phobia would also be helpful for bleeding protection?

On Saturday morning, Jim was leaving for the trial to go scratch Hardee and pack up our set-up when Hardee jumped up and wanted to go with him.  Because right then HH wasn't bleeding, we let him go, and Jim was going to play it by how the bleeding looked if it started again.  Please keep in mind that we promised Hardee, through an animal communicator, that he could run agility until the end in exchange for letting us put him through all the radiation and chemo.  Hardee ran great in all three of his runs, with great times, so a triple Q.  His bleeding was on and off, so I called to see if we could get in to see one of his oncologists on Monday since we were already in SoCal.  The bleeding was mostly gone on Sunday, and once again, Hardee ran great and double qualified.  He has never had that great of an agility weekend before, qualifying in all 7 of his runs.

Hardee's cancer is very deceiving.  The bleeding is painless, though the tumor growth must bother him, and I keep him on pain pills constantly.  Hardee's oncologists say he probably doesn't need the pain pills, but I fear his pain so I give them anyway.  Jim got many compliments on Hardee's great weekend and many "he sure doesn't look sick" comments.  Jim explained, again, that he is not sick, that he has cancer and is dying, but he is not sick.  In our book, there is a big difference.  For those that saw the videos of his Sunday runs on facebook, you'll understand.  A sick dog wouldn't run and bark like that.

Monday, our appointment was at 11:15 with the oncologist.  A CT scan was recommended, as were chest radiographs.  Hardee was taken in back for his exam and to have his radiographs done.  Everything was fine with HH then, and his lungs were clear.  I usually "treat" him after any vet procedure or send treats back with the technicians when he was getting chemo, but he couldn't have treats this time because of the anesthesia for the CT scan upcoming.  Hardee is very smart and figured out quickly that no treats meant more procedures.

Hardee was taken in back again and given a shot of an anti-emetic because we had fed him breakfast.  When he came back out and I couldn't give him any treats still, I could tell he was getting anxious about more procedures.  He wouldn't sit or lay down or relax.  It was like he didn't hear me or just couldn't oblige, and he was panting.  I tried ear rubs and other calming techniques, but nothing was working.  It had been 4 hours now, and we kept walking him outside for air to see if that would relax him more.  When we came back inside he bit at his leash, twice.  I had never seen this behavior before.  I was just going to ask to see if there was sedative that we could give him when they finally called for us.  I tried to warn the technician that he was getting very anxious and he was biting at his leash.  She said, that no, he is fine and assured us that he had been fine when she had him in the back twice earlier.

This next part will be very hard for me to write.  Hardee has been through so much, and it is one of the reasons we stopped chemo because Hardee couldn't handle it anymore, both physically and mentally.  I am to blame, but I write it in hopes that others will recognize earlier that their dog is being pushed over the edge of coping and that their dog might need a sedative to help them cope regardless of what the technician says.
 
The tech took him in the back, and I was almost sick to my stomach to see him walk away so scared.  Jim and I went to the car to sit and wait.  A couple minutes later the tech was back saying that Hardee had lunged at them and tried to bite them when they went to pick him up and put him on the table, that they couldn't get control of him to get a muzzle on him, and that he was biting desperately at his leash.  They took us in the back to put a muzzle on him.  I tried to calm him to no avail, and he lunged at me to attack the muzzle I had in my hand getting my hand/finger in the process of biting the muzzle.  They put us in a room thinking it would calm him down, and they went to get a basket muzzle.  I tried to get that on him, but he attacked that too.  He was biting at anything he could, except us, to get out of the situation.  He was out of control, and I was petrified for him.  Now his nose was really bleeding, and I didn't know what to do.

The tech wanted to get a sedative into him now.  I asked how she was going to do that, and she said that I didn't want to know.  I forced the issue, and she said that it involved the rabies pole and that she wouldn't tell me more.  I sobbed as she led him away and sobbed as Jim and I discussed whether Hardee would be better served if we released him from all this horribleness now.  We just couldn't send HH to the bridge without us being there to comfort him and tell him we loved him, and we couldn't be with him in his state of mind.  We couldn't bear our last memory of him, or his last memory of us, to be like that.  The tech assured us that we shouldn't even be considering putting him down and that he would be okay once he was out of that setting and that it was just fear aggression.  It was a long, horrible wait to see if our boy was going to be okay, and if he would be able to be the boy we knew after what we had put him through.  Even on our drive home, we wondered if we would have to release him to the bridge when we got home. 

They woke him up quickly after his CT scan and brought him to us on a rolling table with a cone around his neck in case he tried to bite them.  As I reached to scratch him under his jaw and on his neck, he was all wet in those areas.  I asked why he was wet and if it was drool because of his earlier emotional state.  They said he wasn't wet and that they didn't know.  Both sides of his nose were bleeding, and as I went to take the cone off of him to load him into his crate, I could smell vomit on my hand.  They denied adamantly that he had vomited with them.  I could no longer argue with them and wondered what hell he had endured in the back.  I just wanted my boy so we could start our long drive home because now it was late.  Hardee's nose bleed had stopped by the time we got home late Monday night.  His emotional state was back to normal also.  Once he was awake from anesthesia and back in the car, he started coming back to his normal self.
 
The results of the scan were not good.  The tumor has extensively progressed into the left nasal passage from where it had originated in the right, but even more devastating is that it has spread up into his left frontal sinus in his forehead almost completely blocking his entire sinus, thus the nose bleeds on his "good" side.  It has only been 5.5 months since we stopped chemo and I was caught off guard how quickly the tumor had progressed and where.  The oncologist thought it was fluid up in his frontal sinus, but I knew it was tumor and the radiologist confirmed my position.

The oncologist recommended palliative radiation on the new tumor in HH's forehead.  That is 5 days straight of general anesthesia and radiation.  We cannot do that to Hardee, again.  We have all reached our saturation point of what we can endure, and I cannot endure seeing Hardee pushed to that state again, day after day.  We feel we have done all that love can do, and all that love can endure.  We will spend the rest of his days trying to regain Hardee's trust and begging for his forgiveness.  When the time comes to release him to the bridge, we will look for an alternative other than taking him into a vet.

Our plan is to start Hardee back on the peroxicam and cyclophosphamide pills that we can give him at home.  The problem with that plan is that he would need to get blood drawn every 3 weeks to check his kidney values.  I plan to speak to the military vet here at Nellis AFB about some Valium that we can give HH at home before we come in for blood draws.  I have to take him for blood draws regardless of whether we start those anti-cancer/chemo pills or not because we are trying to get his thyroid meds regulated that he just started.  I thought Hardee was putting on weight because Jim had hurt his knee and they hadn't been running agility, but no, it was his thyroid being very low (chemo related?).  If he gets too stressed for blood draws after we get his thyroid levels regulated, then we will quit the peroxicam and cyclophosphamide so he no longer needs to go into a vet.

The rest of our plan is to let Hardee continue his favorite sport, when he can, which is running agility, until it is time to release him from this cancer.  The bleeding or his pain that I cannot get under control will dictate when that happens.  The rest of the time he will be doing therapy work at a hospice facility, which I thought was very fitting.  We had abandoned his therapy work along the cancer fighting path somewhere, and I got an email recently stating that a hospice facility was looking for therapy dogs.  Hardee and I have both passed our interview, and I have passed the background check.  We hope to start this weekend, if Hardee is up to it, but it might be after the new year.

I know some will judge harshly our plan, what we have done treatment-wise in the past, that we still let HH compete, what we let Hardee endure on Monday, my ability to judge Hardee's state of mind Monday, etc., but we are already racked with guilt over Monday, so no need to beat us up further.  As far as everything else, dog people can be some of the nicest people ever, but also some of the most judgemental and cruelest.  Some think they know best and have not been shy to tell us.  I would ask that you please keep it to yourself.  Truly, we are doing the best we can with what we know.  I hate that we had to learn most of it at Hardee's expense, but when you know better, you do better.  As far as letting HH still compete, his is an incurable cancer.  He is terminal.  Why not let him have quality of life until the end?  He is not sick; he is dying, and he wants to live what life he has left with joy.  I hope you all understand. 

I realize, now, that when I write in a public forum, people expect to be able to respond, but I write in a public forum so that maybe people can learn from what we have been through.  Maybe someone will recognize the signs and symptoms of nasal cancer earlier for their animal and be able to save them or extend their life out further than we got with Hardee's.  Maybe this blog can act as a resource to guide others through what we have been through.  At the very least, it is a written memory for me of our fight like hell against this horrible disease.  We love our boy so much and hope somehow his fight to live helps someone else.

We don't know how much time we have left with Hardee, but I think you know by now that we will be out having fun until the end.  It is and always will be, for as long as possible, all about joy and all about Hardee.  You know we wouldn't have it any other way.

Thank you to all who have loved and supported us along our journey.  We especially appreciate your love of Hardee.  You have kept us going when our spirits have waned, and you have picked us up when we have stumbled.  From the bottom of our hearts, thank you.  Please keep us in your thoughts for peace and clarity when the time comes to release our beloved boy.

Wed., Dec. 7, 2011 - National Agility Championships

Our fabulous boy did it, again, this year and qualifed for the National Agility Championships.  Jim and Hardee have never participated before because the Nationals have been held too far away, but this year they are being held in Reno, NV, March 30 - April 1, 2012, only about 425 miles away.  The date is too far away to plan on attending because of Hardee's health, but we still hope and dream of the possibility. 

Participation in the Nationals or not, it does not diminish our pride in Hardee and all that he has accomplished in spite of his nasal cancer.  Throughout Hardee's cancer, he has shown us his fighting spirit, his will to live, and his love for life.  We are proud of Hardee not only for what he has accomplished, but mostly we are proud of who he is.  He is a fabulous boy dog, who brings so much joy to all.

We dream of many more weeks or months with our special guy.  While we dream, we'll ensure it is all about joy and all about Hardee.