The Big “C”: Weighing the costs of medical treatment.

Buckley in his element.

This fall we had the misfortune to have both of our dogs diagnosed with cancer within two weeks of one another. Buckley, our 6 year old Bernese Mountain Dog was the first. Diagnosed with systemic histocytic sarcoma (HS), we were devastated, but not terribly surprised, as five of his littermates and his mother had previously succumbed to this virulent, aggressive cancer. Buckley was diagnosed with the most aggressive type of HS (it attacks the red blood cells), after routine blood work revealed his acute anemia which led to the final diagnosis. The day we discovered his anemia, we took him to Medvet Columbus where he spent several days getting treatment that included blood transfusions and his first round of chemotherapy. We were told the average survival rate for dogs with this variety of HS was thirty days. We brought him home on a Thursday with the hopes of keeping him comfortable for what we feared would be his last few days. In fact, the oncologist, Dr. Erin Malone*, told us later she did not expect Buckley to make it to his recheck the following Tuesday.

However, over the course of the weekend he began to eat again (he’d lost nine pounds) and to show interest in the world around him (including a Golden Retriever who walked by the house looking like our dog Hudson, who we lost the year before. In a strange twist of fate, this Golden was also named Hudson!). His fever dropped, his gums were pinker, and he asked to do things like walk down the block. We launched into a regimen of alternating chemo drugs every two weeks and he began to bounce back, gaining fifteen pounds and showing interest in the things he loves: walks, ice cream at Whit’s, hanging out with Brad, and spending his days on the front porch. Buckley has now survived 10 weeks and we are hopeful that he will see his seventh birthday on the 30th of December.** Dr. Malone told me that she has never had a dog with this cancer do this well.

small_heroic_bingley

Mr. Bingley

Histiocytic sarcoma, though rare in the general canine population is common in four breeds: Rottweilers, Golden Retrievers, Bernese Mountain Dogs, and Flat Coated Retrievers (Flatties). It is due to this very cancer that the average life span of Flatties is 7.5 years. Thus, it was with a heavy heart that two weeks after Buckley’s cancer diagnosis, we were informed that Bingley, age ten, also has HS. His variety, common with Flat Coated Retrievers, is soft tissue histocytic sarcoma. He’d had a lump on his left front elbow for over a year that, in all probability was HS, but was misdiagnosed. At a chiropractic appointment, his holistic vet found an enlarged lymph node, took a sample from it and when we got the ambiguous results, it was off to Medvet that day. When the diagnosis came in, I was crushed, but not terribly surprised. Bingley started the same chemo regimen as Buckley, and has responded well, though with a few more side effects than Buckley experienced. The lymph nodes are undetectable, the lump on his leg has reduced significantly and in general he remains my energetic, goofy retriever self. Given how quickly this cancer can progress, we are grateful for each day we have with Buck and Bing.

Knowing that cancer is endemic to Berners, we purchased pet insurance for Buckley. Just one ACL surgery, or cancer treatment more than makes up for the monthly premiums. They have paid 90% of the cost of Buckley’s treatment. Without this financial infusion, we would have been hard pressed to pay for one, much less two courses of cancer treatment. To date, Buckley’s treatment has cost well over $6000.00, Bingley’s over $3000.00.

Our first dog, Bandit.

Our first dog, Bandit.

This is not the first time in 34 years of marriage we have had to face expensive medical bills for one of our dogs. We have not always chosen to pursue extensive care. Making the decision to not treat a condition is not easy, but we tried to weigh in all pertinent factors, including such things as age and general health of the dog, likelihood the treatment would be successful, cost of the procedure, other treatment options, and our current financial situation. For example, when Brad was in law school, our small dog ruptured his ACL. Bandit was only 5 years old and to not repair it would mean he would not have full use of his leg and be in constant pain. He was a healthy dog with many years ahead of him, so we opted for the surgery we could ill afford, and called it our Christmas present to one another.

Rebel

Twelve years ago, one of our dogs, Rebel, had a neck injury and the cost of having an MRI and surgery was over $3000.00. The alternative treatment, steroids, was $20.00. We opted for the steroids as $3000.00 was not in the budget. Lucky for us, the steroids worked, but if they hadn’t I don’t think we would have pursued the more expensive treatment as we had a daughterIMG_2155 heading to college the next year. Another dog, Bilbo, developed an anal cyst that could have been operated on ($1000+), but he was 11 years old and the surgery would not guarantee that the tumor would not return within 6 months. Given his age and general health, we elected to keep him comfortable for the remainder of his time with us.

We have had the distinct pleasure to have had 8 dogs share their lives with us and each one has given us great love, as well as medical challenges. There is no one right way to deal with the medical issues our canines face, and the decision to treat or not treat has several factors, each of which must be weighed according to your individual situation. Do not feel bad if you choose at one point in your life to pursue treatment, while at another time you do not. Each dog, each stage of our lives, is different and will require a decision based on the pertinent factors at the time.  These decisions do not reflect on how much you love your dog, but only that you love your dog and will, to the best of your ability, do what is best for all involved.

Bingley, Rebel, and Hudson

*We have nothing but high praise and gratitude for Dr. Malone and the entire staff at Medvet. The oncology unit has gone out of their way to care for Buckley and Bingley, as well as us. We are also grateful to the internists and ER doctors who have also cared for Buck and Bing during their cancer diagnosis and treatment. They have made a very difficult time as easy as possible. And of course, our family vet, Dr. Chad Herrick and his staff at Northtowne. They have loved and cared for our canines for many years, and without them, Buckley would not have been sent to Medvet that first day.

**1/11/16 Update: Buckley did indeed make it to his 7th Birthday. He had a blood transfusion the day before and was feeling well enough to go for a walk, engage with people and dogs, and eat ice cream. The transfusion kept him comfortable for a time, but he finally succumbed to his cancer on January 8, 2016, dying peacefully at home with Brad and me. He was a sweet, goofy, loving, giant of a dog and will be forever loved and missed.

Care and management or living together in harmony General Informational or Doggie Demographics Toy Box or stuff that doesn't fit neatly elsewhere5 comments

5 Comments
  1. Sheila Cline says:

    Julie and family, it sounds like Bing and Buck are doing well and possibly bless your home for another Christman. I enjoyed your article and meeting some of your beloved pets. God Bless and Merry Christma

    • Julie Smith says:

      Thank-you Sheila for your kind words. Buck and Bing are doing remarkably well and we feel very lucky that they are responding so well to the treatments. Merry Christmas to the Cline family and see you in the New Year!

  2. Julie – Great, heartfelt advice. As you know, we’ve been down the same road many times, and the decision is always different. You described the decision-making process that we have used perfectly.

  3. P.S. – Appreciate you sharing something so personal for our benefit. Glad B&B are doing so well… they’re lucky to have you!

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