February 10, 2011

February 10, 2011

There are certain dates in everyone’s life that they will never forget. February 10, 2011 is one of those days for me. On that day, a piece of me died.

The day started like any other day. I woke up and Bailey was already downstairs eating his breakfast. After a quick shower, I took Bailey to Urban Dog for a day of fun with his buddies. Late that afternoon I did something I rarely ever do—I turned my cell phone off so I could give my full attention to a meeting I was attending at a downtown law firm. My cell phone is always on—even in the middle of the night.

At about 5:30 pm the phone rang in the meeting room at the law firm. The lawyer who answered the phone turned to me and said: “Rob, your father is looking for you very urgently.” As I picked up the telephone I heard my father say: “Rob, your dog is very sick.” Tears welled up inside and I began to feel the worst pain I had ever felt in my entire life.

My mother had picked Bailey up from Urban Dog where he had been vomiting and had diarrhea. Melinn and Mom were taking Bailey to the Veterinary Emergency Clinic to meet Dad and I. How could this be the end? He was doing so well.

When I arrived at the clinic, Bailey greeted me with his tail wagging. I looked into his eyes praying that he would tell me if he was ready to go. But there was no sign. To me Bailey looked full of life. We had too many adventures left for this to be the end.

Sometimes our heads tell us things that that the heart wants to hear. The reality was that the tumor had grown and was blocking Bailey’s urethra causing his bladder to fill up. There were a few options but none of them were very good. If we did nothing, Bailey’s bladder would explode (actually giving him some relief) and he would have maybe 12 hours to live. Alternatively, we could have tried a catheter to empty the bladder—but even if that worked his bladder would soon fill up again. And if the catheter punctured the tumor Bailey would have to be put to sleep immediately.

This was really the end and I had just one decision left: Put him at risk and watch him suffer or allow him to go peacefully before any of the serious suffering began. I looked to Melinn and my parents but they knew that the decision had to be mine. And while I could not bear the pain of living without him, the pain of watching him suffer would have been worse. With tears in my eyes I told the vet and my family that we would let him die peacefully that night.

My parents waited at the clinic while Melinn and I drove home to get Elle and Ivy. As I have said before, Bailey belonged to everyone—not just me. Elle and Ivy had known Bailey their entire lives and we wanted to give them the chance to say goodbye.

So on a cold winter evening my Melinn, my parents, Elle, Ivy and I sat in a room saying our goodbyes. We fed Bailey treats, took pictures and told him how much we loved him. When it came time, I asked everyone to leave Bailey and I in the room alone. I just figured that it all started with just him and I—and it should end that way too. I hugged him and kissed him and asked him to wait for me at Rainbow Bridge.

Bailey slowly drifted off to a deep painless sleep…and he was gone.

There are no words in the English language to properly describe the pain I felt or the love I still have for him. He was my best friend and greatest teacher in the most formative years of my life. I hope he is watching over me knowing that he changed my life forever. I hope he is proud of me and what he created. I hope I can live my life in a way that gives honor to his memory.

I love you Bailey and I always will. Rest well.

Belle’s Ace Bailey
December 2, 1997 – February 10, 2011

Treatment

Treatment

The Guide taught me more than I ever wanted to know about cancer in dogs. I learned new terminology that would help me ask the right questions and select the right treatment for Bailey.

In mid-January Bailey had a biopsy to determine the root of the cancer. While I hated the idea of sedating him, the biopsy was because knowing exactly what we were up against would determine the appropriate course of action. After the procedure, Bailey looked like he had been on a bender on St. Patrick’s Day at an Irish pub. He was wobbly and unsure of himself. I began to second-guess myself. Should I have put him through this? Was fighting the right option? But the next day, Bailey was back to being Bailey. It was as if the day before never happened. There would be no more second-guessing. We would continue to press on.

Unfortunately surgery was not an option and neither was radiation. Neither had proven to be successful in treating Bailey’s type of cancer. The only option was chemotherapy. Chemo brought both good news and bad. The good news was that chemo is administered to dogs in much lower doses than for humans. As a result, the chemo would not be painful and would at worst, cause some nausea and vomiting. The bad news was that chemo was not a cure. In many cases, chemo could extend the quality and quantity of life for another three months. The oncologist at the Veterinary Emergency Clinic provided even more hope when he said that Bailey could even have a year or more.

Despite all this information, I was not done asking questions. I needed a second opinion. A few months earlier, the Board of the Ontario SPCA retained former University of Guelph Vet School Dean Alan Meek to conduct an investigation of the ringworm outbreak at its Newmarket shelter. I reached out to Dr. Meek to see if he could introduce me to the chief veterinary oncologist at the University of Guelph. A few days later, Bailey and I drove to Guelph to meet Dr. Paul Woods.

Dr. Woods and a team of three other vets greeted us with open arms. They examined Bailey and spent almost two hours answering questions about possible treatments. They were warm, caring and compassionate—and for that I am eternally grateful. I realize that we probably received special treatment because of my role with the Ontario SPCA but if it weren’t for Bailey I would have never volunteered my time to the cause of animal welfare.

I left Guelph with the confidence that chemo was the right route to go. Although I would have been willing to drive to Guelph for Bailey’s chemo treatments every three weeks, Dr. Woods gave his full endorsement to Dr. Kevin Finora at the Veterinary Emergency Clinic in Toronto.

On January 26, 2011 Bailey went for his first chemo treatment. Unlike the biopsy a week earlier, Bailey responded to chemo with flying colors. There were no adverse side effects—no nausea, no vomiting, nothing. Even when Bailey went for a follow up visit ten days later, Dr. Finora was impressed with how well Bailey was doing.

I was more hopeful than I had been in weeks. Bailey was going to fight for every moment and for every day. I knew there was no cure, but at least we had some time…or so I thought.

My Guide

My Guide

I call this journey the Cancer Iditarod. Once you find yourself on it, you must follow it all the way to the end. There are no easy off-ramps on this highway, and you must get used to the rules and the pace.

It’s totally possible to do this, especially since your partner is your dog—probably your best friend and the best team player you could wish for.

Dog Cancer Survival Guide, Demian Dressler, DVM

The first step in our fight was to find out everything. To educate myself so I could ask the right questions and select the best form of treatment. This brought me to Demian Dressler’s Dog Cancer Survival Guide. Dr. Dressler’s book appealed to me for several reasons:

Firstly, The Guide takes a Full Spectrum approach to cancer treatment. It looks at both traditional veterinary medicine as well as alternative strategies as part of its overall approach to fighting this killer.

Secondly, it identified me, Bailey’s owner, as his Primary Health Advocate. I am his best friend and his father. Only I could make the decisions that are best for Bailey.

Thirdly, The Guide did not try to act as a substitute for in-person veterinary advice. Rather it sought to arm me with as much information as possible to allow me to fulfill my role as Bailey’s Primary Health Advocate.

Fourth, it provided a keen insight into the mind of a dog. Whether I realized it or not, Bailey could sense my emotional state. I had noticed this anytime I was sick or sad—Bailey just knew. My emotional state was important not only for Bailey, but to allow me to make the very best decisions regarding his well being.

Lastly and possibly most importantly, The Guide provided hope. It reminded me that “a cancer diagnosis does not equal instant death”. And there was still some life to be lived—and still an opportunity to love and express that love.

In providing the overview of its Full Spectrum Cancer Care, The Guide provided this quote from Lance Armstrong:

If children have the ability to ignore all odds and percentages, then maybe we can all learn from them. When you think about it, what other choice is there but to hope? We have two options, medically and emotionally. Give up or fight like hell.

The opening chapters of The Guide were aimed at helping me understand the nature of the Cancer Iditarod and prepare me for becoming Bailey’s Primary Health Advocate. One of The Guide’s many exercises was designed to help me get reconnected with Bailey. Now, I know what you may be thinking—this is all hocus pocus. How could anyone me more connected with their dog than I was with Bailey? But life had become busy. Between work, three growing children, my time with the Ontario SPCA and other leisurely pursuits I had somehow neglected my “Ace”. And now it was time to fix this.

The exercise of telling Bailey his Life Story not only assisted in reconnecting with Bailey, it also helped me remember many of the stories that I have written about in this space. It also allowed me to focus less on my own feelings of distress and more on Bailey and the battle he was facing.

So on a cold winter night in January while Bailey lay quietly on the couch in our basement, I kneeled on the floor beside him and told him his Life Story. I gently stroked his head and started from the first day I held him in my arms. I laughed a little but I mostly cried. I reminded him of all our adventures. I spoke of our time in California and our many trips to Florida. I also told him about all the important events in our lives and how he had touched all of us in a way that I couldn’t fully comprehend. I also talked about the non-events in our lives—the times when we just hung out together on a warm summer day or on a night at home in front of the television.

I had my doubts about actually telling Bailey the story of his life. I, probably like you, thought that this kind of thing was too touchy-feely—even for me. But I trusted Dr. Dressler’s words that after I finished telling Bailey his Life Story I would understand why—and I did. After 13 years together, I didn’t think I could love Bailey anymore than I already did—but I was wrong. On that night, I fell in love with him all over again, just as I had 13 years earlier in Simi Valley, CA.

Cancer is horrible. It robs us of the most important things that we have. But if there is anything good that I can take from this whole experience its that it gave me the chance to thank Bailey for being my best friend and provided me with opportunity to fall in love all over again.

The News

The News

I walked through the front door and Bailey greeted me with his tail wagging—but something was different. He wasn’t himself. He was slower and more lethargic than usual. The medication had helped him pee but he wasn’t 100%.

The next day I called Dr. Tung to ask about a stronger, more aggressive medication for Bailey. Dr. Tung prescribed the stronger meds but suggested that if Bailey isn’t back to normal in a few days that I should take him for an ultrasound. Sure enough, the stronger medication worked and Bailey was back to being Bailey—but not for long. After the stronger medication was finished Bailey once again struggled to pee. I reached out for Dr. Tung once more to get another prescription, but no dice. Dr. Tung told me that if it was a urinary tract infection it would have been cured by now and Bailey would have to see a specialist and have an ultrasound.

The specialist’s office was located in the Veterinary Emergency Clinic—a 24-hour animal hospital where sad news is dispensed on a regular basis. The specialist, Dr. Mason lacked the warmth and compassion that I had hoped for—everything was just a matter of fact with him.

Dr. Mason examined Bailey before taking him in the back for his ultrasound. “What do you think?” I asked nervously. “Well, dogs his age that have this problem usually have cancer, but let’s see what the ultrasound says.” My eyes filled with tears.

There it was--the enemy staring us in the face. The bullet that had been dodged for 13 years. What were the odds that Dr. Mason was wrong? What would the ultrasound tell us? The two hours that followed were two of the longest hours of my life.

Melinn and I returned to the vet clinic where Bailey was thrilled to see us. To him, it was just another adventure. To Dr. Mason, it was a time to deliver the news. “Bailey’s ultrasound was not normal,” he said. I broke down. There was no possibility of keeping it together. Dr. Mason continued: “We can see a thickening of the bladder wall and spots on his urethra.” I looked over at Melinn to see tears running down her face. “How long does he have?” I asked. By now, Dr. Mason could tell how badly we were taking the news. “Now, what I am going to tell you is extreme. If his urethra becomes blocked, it’s a matter of just a few days. But on the other side of things, he could last three to four months.”

Dr. Mason outlined the two options: Do nothing and let nature run its course or chemotherapy, which would first require I biopsy to properly identify the source of the cancer. I was confused and conflicted. After hearing the word “cancer” not much else made much sense to me. I knew I wanted Bailey to be with my family for as long as possible but at the same time I could not bear to watch him suffer.

To fight or not to fight. We decided to take Bailey home to weigh our options. That night, somewhere in the midst of a million tears I decided that I would arm myself with as much information as possible. I realized that Bailey had no idea that something was wrong—and as long as it stayed that way I decided that the best option was to fight…and fight hard.

The Phone Call

The Phone Call

In December 1997 I opened my heart for the first time in my life. My love for Bailey made my heart grow bigger. This overwhelming love also made me keenly aware of my vulnerability: One day Bailey would be gone and life would never be the same.

As Bailey got older I became more vigilant in watching for signs of potential illnesses or other health problems. In my own mind Bailey was doing well if he was eating, sleeping, playing and going to the bathroom on a normal schedule. My concern for Bailey led to my decision to reduce his time at Urban Dog from four or five times per week to two or three times per week. This way, I could make sure that Bailey was active enough to keep him young and healthy, but not so active as to wear him down.

Fortunately Bailey steered clear of any serious health problems for three full years following his 10^th birthday. In December 2010, Bailey turned 13 and I had planned to celebrate by throwing him a Bark Mitzvah—as if he was a Jewish pup becoming a dog for the first time. However, December 2010 had proven to be a busy month. My daughter Ivy turned four, there were several year-end holiday parties and my family had planned our annual trip out to Edmonton for Christmas and Miami for New Years. The Bark Mitzvah, we decided, would be in January 2011.

Unlike some of the previous years, we made the decision not to bring Bailey to Florida. The drive was too long for both Bailey and I. Instead, Bailey would stay with my parents and his best friend Tetley.

On January 4, 2011 Melinn and I took the kids to the Shake Shack in Miami Beach for the last dinner of our vacation. The next day we would return home to Toronto—back to work, school and of course, Bailey. And then the phone rang.

The voice on the other end of the phone was my father. Bailey had been struggling to urinate and they had just returned home from Dr. Tung’s office. While there was no definitive diagnosis, Bailey was put on medication to help him pee. If the medication worked, the likely cause was a urinary tract infection. If the medication, did not work we would have to send him for more tests.

That night my heart sprung a tiny leak. Even though I kept telling myself not to jump to conclusions, somehow I knew we had reached the beginning of the end. The Bark Mitzvah would be put on hold. I couldn’t wait to get home.

Wondering How It Might End

Wondering How It Might End

For Bailey’s 10^th birthday we celebrated by throwing a party at Urban Dog. We had rented the entire place so friends and family could pay tribute to the dog that had become everybody’s friend. Dogs played in Urban Dog’s huge recreational area while owners and friends enjoyed food and drinks up front. We even had a birthday cake and sung Happy Birthday to Bailey. I remember thanking everyone for coming and declaring that the next big celebration would be his Bark Mitzvah when he turns 13.

Yet amongst this happy group of people and canines I found myself worrying about the time that Bailey and I had left. By all accounts Bailey was in perfect health. At the same time I knew that 10-years old was a long life for a lab. Although I told no one, my biggest fear was finding out that Bailey had cancer. I remember the story of a colleague’s yellow lab named Reagan. Reagan was about Bailey’s age when he was diagnosed with cancer—and it took Reagan’s life very quickly. By the time the vet had identified the cancer, Reagan lasted only a few days.

What would life be like without Bailey? I couldn’t bear the thought.

From that point on, every time Bailey’s sensitive stomach began acting up I wondered if this was the beginning of the end. Would he ever eat again? Would I have only a few days left with Bailey just like Reagan and his owner? And every time Bailey bounced back and began eating again I would tell him: “Keep dodging bullets Bails. I need you with me.”

Sometime around his 10^th birthday Bailey developed a small lump on his side. Once again, the thought of cancer dominated my thoughts. Although Dr. Tung didn’t think it was malignant we wouldn’t know for sure until the lump was removed.

In typical Bailey fashion, he rebounded from the surgery like nothing happened. In fact, the surgery took a greater toll on Melinn and I. Melinn was horrified to see that a large part of Bailey’s left side had been shaved. I think it may have been the first time that Bailey’s mortality became real for Melinn.

But the surgery was not even half the battle—we still had to get confirmation from the lab that the lump was not cancerous. When I saw Dr. Tung’s number appear on my call display, my heart stopped. “Its just as I thought”, Dr. Tung said. “Its benign.” I was overcome with a sense of relief. “Dodged another bullet Bails.”

Each successive trip to Dr. Tung’s office brought more and more questions about Bailey’s health. Every time Bailey had his blood or stools tested I worried about the result. It seemed that every older dog I had ever heard of had lost a battle with cancer. How could he ever avoid this fate?

While living in Dunedin, FL I remember reading about the oldest dog on record—a 21-year old yellow lab. I would remind Dr. Tung that 21 was the goal—I reminded Bailey too. “Hang in there Bails. We’ve got lots of time left.”

I wish I was not writing. I wish I could tell you that 21 was still the goal. But in January 2011 we had we began what was the beginning of the end…