The featured photo is Arran this morning. He was able to jump up on the bench for the first time in a couple of weeks. Two days ago, he jumped up on the bed by himself. Why? Because he wanted me to share my lunch with him.

Wow… Wednesday, already! Tomorrow, it will be time for Arran’s third chemotherapy appointment. I don’t necessarily enjoy hanging out in the vet’s office for an hour while he gets his treatment, but Bill and I have both been loving the results of the chemo. It’s giving us precious time with a very special and wonderful dog. Arran clearly feels so much better than he did a couple of weeks ago. I still don’t know how much this will cost, but at this point, I think whatever it is will be worth it.

Last night, as I was watching Arran interact with his beloved Bill, I went looking for blog posts by people who have also made the decision to treat canine cancer. I didn’t end up finding any blogs, although I will admit that may be because we were distracted by The Trump Tapes. It’s a new Audible book put out by the veteran Washington Post reporter, Bob Woodward, that reveal 20 interviews he conducted with Donald Trump. I can barely stand to listen to Trump speak, but I decided that book would be interesting, so I downloaded it. Bill and I listened to a large part of it last night, although I will admit as the evening wore on, we were less attentive.

In any case, while I wasn’t paying attention to Woodward’s interviews with Trump, I went looking for first hand accounts of canine cancer treatments. I found an article that was published last summer in the Washington Post. I have unlocked it here for the interested. The piece, by Kim Kavin, was titled “My dog needed advanced cancer treatment. The price tag stunned me.” Kavin, whose article was published on July 24, 2022, wrote about her 12 year old dog, Blue, and the cancerous tumor he developed that was causing him to have a watery eye. Kavin happened to have pet health insurance for Blue, which enabled her to access the high tech treatment for the dog’s cancer. Still, the cost of treating the cancer was formidable. From the article:

It was a cold shock of reality when I added up Blue’s total projected expenses on paper. Getting the best available treatment for his tumor could cost more than $15,000 — and that was if everything went right. I’d already spent a lot. And it was unclear how much time it would buy him.

The oncologist at NorthStar VETS in New Jersey said they make sure pet owners understand up front what they’re getting into financially because many people can’t afford that kind of cost — many don’t have enough money in the bank to cover their own, or their kids, medical care. The call like the one I got is usually the heartbreaking beginning of the end of their pet’s story.

Kavin happened to live near NorthStar VETS, a high speed veterinary clinic that offered advanced oncology services for dogs. She had also spent about $700 annually to insure Blue. Because of that, she had the opportunity to access cancer care for her admittedly old mutt. Kavin still had to use her credit card to pay for the services until the reimbursement came from the insurance company. Also, Kavin explains that there aren’t a lot of veterinary oncologists available, particularly given the huge surge of “pandemic pets”. She was fortunate, though, in that the vets were able to get to Blue and start the treatment before the cancer killed him. Kavin writes:

Within a week, the CT scan and consult with a radiation oncologist were done, and within two weeks of the initial trip to my regular vet, he began the first treatment. About 48 hours after his treatment was completed, he was back to bounding around the park and chasing squirrels in the backyard. He had no side effects other than temporarily needing drops in his eye, which was dry. There was a lump on his face where the cancer mangled some bone, but he’s on the doggy version of ibuprofen and showed no signs of discomfort.

Sadly, in Blue’s case, the cancer did come back with a vengeance in June. In July, Kavin wrote that Blue didn’t have much time left. But she also wrote this:

He has been comfortable, and on pain meds, and I’m at least comforted that I did everything possible for him. We gained another two to three months of walks in the park, swims in the river and snuggles in bed.

If I had to do it over again, I would do the same thing.

I’d pay double.

I’ll be honest. I was very skeptical about trying canine chemo. When we learned that Arran had lymphoma, I figured we would be saying goodbye to him within weeks, especially given that it took some time to get the diagnosis and arrange for the chemotherapy treatments. Arran is 13 or 14 years old, which means that he’s lived a full life. The practical side of me told me that treating him was a dumb idea that would cost too much money, and be inconvenient and annoying for us, even though I know that healthcare and veterinary care is significantly cheaper in Germany than it is in the United States.

I didn’t worry about Arran being sick from the treatment, as I knew that dogs don’t get the same amount of medication that humans do. The focus on treating animals with cancer isn’t so much about curing it. It’s about improving the quality of life for the time they have left. I had expected our vets to give us some steroids to make Arran comfortable, which is what we did for our previous dog, Zane, during the week we had him after he was diagnosed with lymphoma. Zane wasn’t as healthy as Arran is, and we caught his cancer later. I also suspect that the type he had was more aggressive than what Arran has (B cell lymphoma).

Our vet said that they didn’t typically give steroids to dogs with lymphoma that weren’t undergoing chemo. Basically, it sounded like we could choose chemo, or we could just wait for Arran to get really sick and die. Bill had to go away on business for two work weeks this month. Arran and Bill have a very special bond, and I worried that Arran would decline while Bill was away. The vet said she thought that, in spite of his age, Arran was a good candidate for treatment. Moreover, we could get the treatments in her office, which is maybe two or three miles from where we live, rather than at the local high speed vet hospital. So then we decided that we might as well give chemo a try. At worst, the treatment would kill him, which the cancer is eventually going to do, anyway.

Two weeks ago today, I sent Bill an angry email, because Arran was getting sicker and was in obvious pain. I was pissed off, because I didn’t want him to hurt. Our first chemo appointment was for the next day. Bill called the vet, who prescribed painkillers. I picked them up and gave one to Arran, who seemed to feel better after taking a dose. Then, on Thursday afternoon, October 13th, we finally went in to see the vet for cancer treatment… You can see from the photos, Arran looks a little bit sad.

I took Arran home with some Prednisolone and Endoxan, another chemo drug. I gave them to him with his dinner. Then, he slept for the rest of the evening, until the wee hours, when he woke me up for a bathroom break.

The next morning, Arran was clearly feeling noticeably better. As he was getting sick, he was not wanting to get up in the mornings. But on Friday morning, October 14, he was up early and ready for his breakfast. He continued to improve all week until last week’s treatment, when the vet said that based on his blood test, Arran’s bone marrow appeared to be working to replace his low red blood cell count. He’s had almost zero side effects from the chemo whatsoever. His lymph nodes have gone back to normal. He’s eating, sleeping, taking walks, and demanding food. Best of all, he made it through Bill’s business trips, and they are now spending precious time together, making their last memories.

After I read Kavin’s article in the Washington Post, I checked out the 734 comments that were left by fellow readers. Much to my shock, the vast majority of them were about how stupid, pointless, and even cruel it is to treat canine cancer. I noticed a lot of comments from people who complained about dogs getting treatment that human beings can’t get. Below was the first comment– it was one of eight highlighted by the WaPo:

I’m actually kind of mad that veterinary medicine is expanding into things like cancer treatments and canine dissociative order. I love my pets with every fiber of my being and yet, putting them through these treatments doesn’t seem like kindness. You can’t explain to your dog or cat that scary and painful days at the vet hospital are “for their own good” and will, hopefully, make them feel better eventually. They are just scared and alone and in pain. It’s one thing to improve on surgery techniques so that a dog hit by a car has a better chance to fully recover. Putting them through radiation treatments to get a few more months of walks in the park just seems selfish. I ugly cry when my pets pass on because I am personally devastated, but I know it was time. I don’t want to also feel guilty because I didn’t do absolutely everything the vet suggested.

This was the third comment:

I am a dog lover. I have always had a dog. My Blue Heeler is curled up beside me as I type. I am also a Buddhist who believes, as the Buddha said in so many words, that the root cause of suffering is clinging to the delusion of permanence. Everything ends, and it was this dog’s time. I can’t conceive of putting a canine through chemotherapy with no chance of a cure. But that’s just me….

Still another:

Are you doing this for the dog, or for yourself?  

The overall average lifespan for dogs across breeds is 10 to 13 years. Subjecting a 12 year-old dog to the discomforts and fatigue of radiation treatment, making the last months of life a combination of misery and confusion, doesn’t sound like you’re doing it for the dog.  

There are literally hundreds of thousands of young dogs needing adoption. Give one of them the gift of a long and happy life instead. 

and…

There can be a point where care is more about the humans than the animal.

These weren’t the worst of some of the judgmental, and frankly ignorant, comments left on this piece. Here are a few more samples from the comment section:

• All who were surveyed said they would do anything to save their pets. But, would they all subject their beloved pets to radiation and/or chemotherapy, not to save them but to prolong their lives for months, a great part of which is treatment and not good times? They have a shorter life span than humans. You will have to grieve at some point. 

• Would you put a 70-80 year old human through these painful treatments at the end of their life? I hope not. Not even our SCOTUS fools would make someone go through this to “maintain” life!

• I understand the impulse to do anything you can for your beloved pet. I love my own dog to distraction. But I also feel deeply ambivalent about extended medical treatment for pets. They cannot be protected from the pain that cancer patients go through. They cannot consent. They do not fear death, as we do. The veterinarians are making a fortune off of people’s delusions. Many of these owners cannot afford these treatments, and they are often done on dogs who are within a few months of their natural lifespans. People bankrupt themselves for their pets out of love, but also out of guilt. Think of what you are putting your beloved pet through for the potential of a few more months of limited life. Ask yourself if you are being selfish. Think about whether your vet is taking you for a ride. Sometimes the best thing is to send your dear one off to chase balls in dog heaven, spared from months of agonizing treatments. Think of them, not yourself, and ask it it’s time to let go.

• I adore my dog, but I am damned if I am going to torture her so my mourning of her death gets delayed by 6-12 months. One of the many reasons dogs are superior to humans is they do hot have our irrational fear of the inevitable.

• Nope. I wouldn’t do this. You put your dog through a hell which he did not understand.

• To torment an animal for your own guilt is unconscionable. We had a galah with major medical issues. She received 5 medications twice daily for 3 years. She was clearly miserable. We probably spent $50k between the time she became obviously ill and when she finally died. I hated it. I don’t begrudge the money, my husband’s bird, his money, I had no right to complain. But it broke my heart to see her tortured and tormented and so obviously feeling miserable. I shed a lot of tears over the poor thing. She finally died over a three day weekend when she cratered badly and we could not get her to her vet because they were closed and did not do emergencies. The question, to me is, are you prolonging the agony because of your own guilt? Or for the “benefit” of the animal who has no idea what is happening?

• It’s disgusting that expensive technology and expertise that could be used to heal people is being used on pets. We are so wealthy and pampered in this country that even the slightest inconvenience and sadness to us is worth the price, we would never consider spending this money on a poor human that we did not know.  Do the right thing, shoot the dog and donate the money you saved to a charity that helps heal people instead. People are more important than pets.

• Oh, judas priest.  It’s a dog. A 12 year old dog. If it’s in pain, you put it to sleep. Otherwise you let nature take its course. And then you get a new dog. Which you’ll do anyway, since a 12 year old large dog has a life expectancy of around 0. People have their priorities so amazingly f’ed up these days.

• So many people cannot afford healthcare, and people are using tens of thousands of dollars to extend the lives of dogs, whose lifespans are little more than a decade. That seems gross, no matter how much you love your dog.

It’s not that I don’t see their points, on some level. Like I said, Bill and I weren’t keen on putting Arran through any “painful” treatments, either. But before we made our decision, I noticed how he was behaving. In spite of his swollen lymph nodes, he was still engaged with us, and even wanted to play with his toys. He still wanted to take walks and cuddle on the couch. And you’d really have to see how bonded he is with Bill. He adores him.

We had another dog who was like Arran when he had cancer. That dog, whose name was Flea, had prostate cancer, which was truly horrible and painful, and defied treatment. He didn’t want to die. It was very obvious to us, even on the day when we decided it was time to let him go. He was still fighting, even as the drugs were taking effect. We see the same spirit in Arran. I hasten to add that our other dogs who have passed– CuCullain, MacGregor, and Zane, did not have that spark to keep going. They were undeniably ready when they passed.

In Zane’s case, he was definitely going to die of the lymphoma on that day, even if we didn’t opt for euthanasia, because he was bleeding internally. In MacGregor’s case, he could have lived a little bit longer with his spinal tumor, but he was clearly in agony. And CuCullain had a very rare, contagious, and painful disease that was certainly going to kill him, but because it was contagious, we couldn’t take him home. We couldn’t afford to keep him where he was, but it would have been pointless, anyway. In those cases, yes, treatment was futile. But it’s not futile in Arran’s case. Treatment can give him some precious time, and allow us the chance to set up his exit from life in the best way.

It’s true that Arran will likely die soon. I don’t know how long the chemo will work. I am at peace with the fact that he’s going to die. Neither Bill nor I are expecting a cure. Even if he got cured of the cancer, he’s old enough to die of natural causes. But I can’t deny that right now, he’s feeling much better, and that is priceless. We have the means to do this, and Arran is obviously up for it. So I don’t feel like what we’re doing is “for us”, or pointless or stupid… To a dog, a week or a month is a longer time than it is for a human being. Six extra months may not seem significant or worthwhile to a person, but to a dog, it’s akin to years of a human’s life.

Aside from that, chemo for dogs is not as horrible as it is for humans. If it was, I would never agree to do it. And when it appears that the chemo isn’t helping or is causing distress, of course we’ll know it’s time to say goodbye. Not everyone who opts for canine chemo is out of touch with reality or selfish.

What really stood out to me in the comments on that WaPo article, though, are the truly mean and nasty comments some people had, calling treating canine cancer “gross”, because humans are “more important” than animals are. First off, how do these folks think cancer treatments are developed? They get tested on animals. Every time a vet treats a dog for cancer, knowledge and experience is expanded, and that makes it more likely that they can help other animals or… perhaps even human beings!

And secondly, most people who opt not to treat their pets are NOT going to donate the money they “saved” by opting out of treatment. It would be nice if they did donate to charities that help humans, but most of them won’t do that. Many of the people opting out of treatment their animals are doing so because they can’t afford it, or because they think it’s pointless and will be painful. I’ll admit, a few weeks ago, I thought it was pointless, too. But now I know better. And the vast majority of people who “save” money by not treating their pets aren’t going to be donating that cash to save humans. I doubt the people who suggested donating money for humans would do it, either.

I was glad to see a few people leaving comments that challenged those who posted that treating canine cancer is “gross” or somehow decadent. I especially liked this lady’s comment:

You can’t save all the people, you can give your pet pet a better quality of life. You can be a drop in the bucket to strangers or provide meaningful benefit to someone your family loves and has contributed meaningfully to your life. I’d say ignoring someone who has been unfailingly loving and supportive in favor of a stranger would be gross.

I also love what this commenter, a veterinarian, had to say:

A lot of these commenters don’t actually know much about veterinary medicine. I’m a veterinarian and when you take into account the advanced medicine that is being performed, this is quite a steal. Can you imagine being diagnosed with cancer, receiving gold treatment care (including radiation) and it costing $15,000 total? Is it for everyone? Of course not, but if you can afford it, it should be a choice. I don’t see why spending that amount of a beloved pet is ridiculous but people spend more than that on vacations, cars, etc. additionally, treatment for cancer in pets is very much focused on quality of life and not just “time.” Although surgery of course can be painful and have a recovery time, most chemotherapy and other options on our pets have few side effects. I refer people to oncologists all the time for advanced care and if they decide not to treat, I do my best to provide palliative care and/or euthanasia when it is time. And for people saying animals don’t understand, I agree, but neither do babies and young children yet no one is saying we should withhold care from them.

I would have been all for opting just for palliative care. For some reason, that wasn’t offered to us at this time. I’m glad it wasn’t, because this is a valuable learning experience for all of us– including the vets who are treating Arran. I know that doing this for Arran will inform us for the future, not just for other dogs, but also for ourselves, should either or both of us be unlucky enough to have cancer.

Finally, here is the best comment I read regarding Blue’s saga:

There’s nothing cruel about trying to give our companions the same kind of advanced treatments we have available for humans. For each pet and each family, it’s a decision that must juggle the age of the pet, the expected lifespan after treatment, the budget — with or without pet insurance — and the families’ needs. Not every dog can get radiation treatment, nor can every family afford this for their pets. 

I’ve made this calculation for my own pets, and sometimes it’s a go for treatment, but other times, it’s palliative care and euthanasia. Either way, no one has any business telling pet owners that they’re cruel to make either decision. If it’s not your pet, it’s not your decision.

When the time inevitably comes to say goodbye to Arran, we’ll send him to the Rainbow Bridge with his favorite people around him, loving him as his soul leaves the mortal coil. And, in the fullness of time, after we have had some time to mourn, we know he will send us a successor. All of our dogs have done that… even Flea did that, and he was the biggest “male diva dog” of all of our rescues combined.

Arran has been a faithful, loyal, and loving family member for almost ten years. I would like to see him make that ten year mark. Maybe that makes me “selfish”, but I can tell that the treatment is making him feel better, and giving him extra time with his favorite human. I don’t see that as cruel, selfish, stupid, decadent, or “gross”. Right now, it doesn’t appear to me that the treatment is causing him to suffer, and it’s the least we can do for him, after everything he’s done for us. When the situation changes, of course we will act accordingly and do what must be done. But we’re not sending him to the Rainbow Bridge before that time, simply because other, uninvolved, judgmental people think that treating canine cancer is selfish or decadent! Those people can seriously get bent!