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Monday, July 23, 2007

Diagnostics and treatment

I dropped Watson off at the vet at 1pm on Wednesday, July 18th. The portable ultrasound doctor visits once per week on Wednesdays so we were lucky that the timing worked out. I went on some errands while they waited for the MD to arrive. He was finally seen at around 4pm; in the meantime, I had returned to the vet hospital and was reading my book in the waiting room.

I knew it wasn't good when the vet came to get me and had Watson's file in his hand. He took me into one of the exam rooms and let me know that they were 90% sure it was lymphoma, although the type of lymphoma was uncertain. The ultrasound showed an enlarged spleen and an enlarged intestinal lymph node that was pressing again his intestinal wall (and causing the diarrhea). They aspirated his spleen and sent the slide out to the lab. The next step was to bring him home and wait.

The day and a half between the initial and the definitive diagnosis was uneventful, except for a suspected seizure at 11:45pm on the night of the 19th. We awoke to Watson wandering around the bedroom and some evidence of the same ropey drool near his bed. He seemed confused for about an hour and then settled down to sleep. The next morning he seemed lucid and normal.

On Friday, July 20th, we finally got the definitive diagnosis. It was lymphoblastic lymphoma, a malignant, non-curable but very treatable form of lymphoma. Our options were plenty in terms of chemo. Rich came home as soon as he got the call from the vet so that we could discuss what we wanted to do. Given Watson's age, we knew that the 5-drug or even the 4-drug options were too toxic for him. The 3-drug protocol would give him at most 12 months, but it was also more toxic.

In the end, we decided that the 2-drug course of treatment (cytoxin and prednisone) would be the best way. It wasn't the least we could do, yet it wasn't so potent that it would harm him.

From the human perspective, I've been quite shocked at the reaction. There have been words of support, but also of criticism. My own sister outright told me it was the wrong decision for him and that I was being selfish. Besides that fact that I was calling her on an unrelated matter, I found that criticism hurtful and heartless. She had lost her beloved black lab a year ago, so at the very least I would have thought she would have asked me if I was okay. Instead, I got an earful of how her decision not to treat him was the right one for me. I am not sure if I can forgive her for those words in my time of worry and need.

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