Sometimes news just sucks....

AP here:

First one of my favorite recent pictures of Tonka.

It is the classic Tonka look - eyes rolled up at me with that big nose in the air and his eyebrows raised. This is my son, my boy, my heart!

How can you not want to pat that head or kiss that nose? How can you not want to move heaven and earth to save him?

So this week he had an MRI and Tonka did really well. Dr. Klaser was prepared to do a rhinoscopy afterwards to biopsy whatever they found if it was accessible unfortunately that did not happen. What did happen is that an MRI that showed a very large, very nasty mass that has taken up his right nasal cavity and gone up and into the space above his palate. It is creeping into the left side and is pushing up through the bone out the top of his nose. That is the lump on the bridge of his nose. It also expends up and into the right eye orbit but at this time is not giving us any problems there. The only way to determine if it is cancerous is to biopsy it from outside - sort of a surgical punch if you will.  I will tell you that statistically the percentage of nasal tumors in dogs is extremely high (in the 80%) so in all likelihood that is what this is.

I needed to know what was going on- I do not necessarily need to know if it is cancer. The thing about nasal tumors in dogs is they SUCK. I have looked at the treatment options and they are all horrible without really great outcomes. Nothing would be a "cure" everything would just buy time (maybe). So we are going to go down the road (however short) it may be of palliative care. I am starting him on a powerful anti-inflammatory and a big dose of "do whatever makes him happy". The plan is to be pain free and happy until we cant be happy anymore. I have no timeline, not really any guesstimate of how much time there is left and if you read the research you will find anything from 3-7 months with just palliative care, no surgery, no radiation. I know everyone loves Tonka - its impossible not to and everyones first instinct is to "save" him- believe me it has always been mine. The reality is there is no "saving" this time. I am out of options - we can play the "what about" game endlessly but it is not going to change anything. I really don't have the energy or the emotional strength to run down the list with everyone so if I tell you we have no options please leave it at that.

I will never forgive myself for not pursuing an MRI in April when he first started having "allergy" symptoms I am not sure if anything could have been caught and dealt with at that time but I'll never know. I am sorry and that's all I can say about it - I will have to live with it for the rest of my days.


The MRI was read by Dr. Amy Tidwell DVM so there is no doubt as to the accuracy of the read as she is an expert in the field. The first sentence of the report starts with "There is a large destructive mall in the right nasal cavity and para-nasal sinuses with extension of mass..." That sentence will replay in my head forever.

I know Tonka is an anomaly and has beaten more than his fair share of odds but that's not going to happen this time. I suggest if you would like to say your goodbyes that you do it soon - but do not cry around him please. He and I do not need the added stress of dealing with negative emotions. I want this time to be happy for him, he has spent the past 5 years bringing happiness and smiles to people and so that is what needs to be returned to him. I have never known a happier, sweeter soul than my boy and I probably wont again....

Will we or Won't we?

AP here:
 I just spent the last hour getting Tonka's gear ready for a trip to CVRC tomorrow.

Tomorrow is the MRI at Veterinary Imaging of the Chesapeake and if all works out it could be followed by a scope with Dr. Klaser. Maybe to flush out what they find (foreign body) or biopsy what is there if it is a polyp or tumor. The bottom line is tomorrow should bring us some answers but.... it is Tonka. There have been so many times that we have done a diagnostic test only to have it be inconclusive or "normal".

Where we going tomorrow?

So will we or wont we get an answer tomorrow that is the question?

I'm hoping for foreign body something quick and easy to fix so cross your fingers for us.

I haven't told him yet that he has to wear his help em up harness - he is going to be pissed....

Out of the Frying Pan and into....

AP here:

Have you ever had fed a dog a bowl of kibble pieces at a time as it was too weak to get up and eat? Have you ever curled up behind a dog with your hand on it's heart all night long to make sure it kept beating? Have you ever softly stroked their head and ears and sang them to sleep?

Well I have and sometimes still do...
I know people don't always understand the bond that Tonka and I have but that doesn't matter. What matters is that I have spent the past 5 years teaching him about the world outside his sightless eyes and protecting him from harm.
We have had adventures across 1000's of miles and met many people and animals and he has spread happiness wherever we went. We have run and wrestled and laughed; and yes my Tonka can laugh.

There is an added bond of trust patience that is created between a blind / disabled dog and it's human. Tonka relies on me for everything now, before it was just to navigate new places but since he can no longer walk I am responsible for 100% of his daily care every minute of every day.
He is an extraordinary boy, a once in a lifetime occurrence and he is not a dog he is so much more. He is the most loving and gentle soul I have ever met. He is my friend, my boy, my son, my heart and there are days like today where I feel I have failed him greatly.

In April his nose was stuffy and we treated him for allergies. In May he was still stuffy and we had his cancer surgery, again still thinking allergies. Maybe if I hadn't been so floored with the cancer diagnosis I would have paid more attention to the nose. In June, still stuffy so the thought now became perhaps he has a polyp and yet still I did not push for a definitive answer. In July still stuffy and now a lump has appeared on the bridge of his nose, why did it take this lump for me to really pay attention and pursue a reason.  I cant answer that question and its killing me.

I can't breathe through my nose....

On Tuesday July 30th Dr. Klaser did a needle aspirate of the lump on the nose and on July 31st the cytology report came back. No abnormal cells were present which is an awesome thing but sometimes good news is not actually 100% good news. The sample contained mixed inflammation cells and some nasal epithelial cells which suggests communication between the lump and the nasal cavity. Essentially this shows that whatever is in the nose is working its way up and out. The thought of my beautiful boy in pain and discomfort with an open wound between his eyes is way too much to bear. The reality that I have let whatever is in his nasal cavity grow for going on 4 months without pressing for an MRI or scope breaks my heart. I am immensely thankful that it is not cancer but I am also not so naive to know that if this thing gets to his brain we are in big trouble. I once had a stress fracture in my foot and a cyst developed over top of that part of bone. I can only think that this cyst on his nose is in response to whatever is in the nose. So all though I am relieved that the lump on top is not cancer I am worried about what lurks below. I did get a pretty good picture of inside his mouth and his palate and there are no signs of anything coming down so that is a little reassuring.

Tonka's Hippo impression

The current plan is to MRI his head and possibly follow that up immediately with a rhinoscopy to get a biopsy of whatever they find. If it is up too far in the sinus cavity where a rhinoscopy would not be effective then an option could be a small surgical procedure like a punch to get a sample. Everything hinges upon the MRI findings and what the Dr.'s are comfortable with that day especially the length of time needed with him under anesthesia. I have looked ahead at possible outcomes and we have discussed possible treatment plans. Between now and the MRI I will be researching what those treatments and drugs could entail.

My Lumpy Nosed Bear

AP here:
Exactly three weeks ago Tonka and I went to see Dr. Roa. In getting him out of the truck I accidentally bumped his head on the back of the truck. Once inside the waiting area Tonka's Aunt Gina came to see him and remarked that he had a knot on his nose right at the bridge. I assumed that it was from our less than graceful exit from the truck. Three weeks later the knot is still there and this past Saturday Tonka got sick. Now my boy hardly ever throws up and I can count the times on two hands that he has thrown up in the past 5 years so off to GAVH we went.

 Dr. Gerity took a look at him and other than the fact that he is definitely having an allergic reaction to something causing his feet to itch and his fur to stain the only thing that could be upsetting him would be some of his medication.  We discussed stopping some of the meds and putting him on something to settle and coat his stomach and then she turned her attention to his lump. Now Tonka has not been able to breathe right out of the right side of his nose since April so the thinking has been that perhaps there is a polyp or tumor that is blocking the passage. The presence of the lump could be whatever is in there pushing up and trying to find a way out, so basically coming up through the bone. Cancer nasal tumors destroy bone and can erode a hole out. The other disturbing trend lately is whenever he stands in his wheels his tongue turns a dark pink. This could be due to something occluding blood flow as well.

The thought of this of course was very upsetting so I made an appointment with internal medicine and Dr. Klaser to take a look and biopsy it. We discussed the possibility of being able to do a needle biopsy instead of a rhinoscopy but to be prepared for that if the lump was too hard to use a needle. A needle aspirate allows a Dr to take a small sample to look at. It is less invasive then a surgical biopsy and there is no anesthesia involved. Anesthesia always involves some risk and recovery time. We were lucky and Dr. Klaser found a softer spot on the lump to do the needle aspirate.

At first glance it appears to consist of mostly cyst cells but some cells were grouped together that looked a little off so we will wait for the final report from IDEXX which should be back in a few days.  So once again in looking for a quick and neat answer to a Tonka problem - well its just not happening. I am relieved that it wasn't a definitive nasty tumor full of cancer cells as that would have shortened our remaining time together dramatically. I am still at a loss about his breathing problem and at this point he basically has very little air flow in the right nostril at all. It doesn't appear that this lump is the cause but again we shall wait for the report to come back.

Holding on to hope......

and T Man sticking out his tongue to Cancer!

The Chemotherapy Whirlwind

AP here and it has been exactly one month since we started down the road of chemo. It has been a crazy time and one that has kept me busy trying to figure out the best recourse for my boy. It has also been very stressful and I felt the need to shut everything down while we were trying to get back to some sense of normalcy. A lot has happened and not all of is related to the cancer. I am going to try to catch the blog up with the events of the last month with the next several posts so please bear with me.

Palladia the chemo drug recommended for Tonka - nice enough sounding drug, the name kind of rolls off the tongue, sounds sorta harmless, like a vacation spot or something. As with all new things and my boy I did my research and joined a few canine cancer groups online and started asking for any feedback from those that had used it. I came up with a mixed bag or reactions, some people loved it, others hated it and due to some rare side effects feel it ended their dogs time early. I was still battling with Tonka's inability to breathe very well and the various medication he was on for that so I was not sure if I wanted to jump in right away. I decided to wait a week and try to get his allergies under control and get him off some of the meds before beginning. Everyone was OK with that and so we went back to our normal routine of therapy and underwater treadmill for the week.

Lately he had been not wanting to lie down on his left hip and seemed to be having a hard time rolling up on his side without help so I was hopeful that he just had rib out again and therapy would help. He did seem better after his therapy session and so we kept up our routine and had a treadmill session a few days later.

He did really well in the treadmill and I know he enjoys it because he can actually run and move his legs like nothing is wrong. It was nice to get back to our routine and everything seemed to be getting back on track except his sense of smell. He was still so congested that I wanted to postpone chemo one more week but was advised that I needed to start immediately as the tumors were an aggressive type. The weekend came and went and his sense of smell was no better but it was now Chemo week so the Tuesday morning of May 28th we headed to therapy with an oncology appointment right afterwards.


Therapy did not seem to help much and he was still in pain while we were waiting in the lobby. Dr. Roa came through and he did a quick check of him but couldn't find anything. Then Dr. Klaser arrived for his chemo consult and we discussed that he seemed to be in pain lately and she suggested an ultrasound of his belly as well as the blood work he was already there for. We hung out for awhile till they were ready for him and all his friends came by to say hi and to give him attention. When they took him back for his blood work and to check his abdomen I sat in the lobby and semi successfully tried to keep it together.Dr. Klaser returned after his exam and we talked about the fact that he is just not himself and seems in pain. She did not see anything on the ultrasound and his blood work was fine so the only thing left was to pick up the chemo meds that afternoon and start them the next day.

I took him home and made him comfortable and put some ice packs on his neck and ribs and he was soon fast asleep. That afternoon I drove back to CVRC and picked up his meds and received the instructions on what to give him and when. The biggest 2 things to look for were diarrhea and vomiting and anything more than once was a red flag.I drove home with his little blue bag of pills and a lump in my throat.

The thing about chemo meds is that the medication can be present in the urine, feces and saliva so anyone handling those things should wear gloves. Since Tonka is incontinent and has to be expressed manually that meant that Caitlin and I had to wear gloves and dispose of his pee pads and poop bags in sealed plastic baggies. I put boxes of gloves in strategic locations and covered the carpet with contractors sticky back plastic to make sure if there were any accidents the mess would be minimized.


Of course the next morning (the first day of chemo) Tonka decided to not eat anything for breakfast.When I say anything I mean anything - nothing would entice him not even his favorite treat. I ended up scrambling a couple of eggs and he did eat some of that but I was not happy giving him all that medicine on a partially full stomach.

the list of meds...
4 pepcid AC's twice a day - before meals
Metocloprimide - 3 a day
Palladia -90Mg on Mon/Wed/Fri

At this point he was already on Hydroxyzine and Amoxicllian for his stuffy nose and his daily thyroid med. If you follow the blog you know he is a sensitive moose when it comes to medications so I was worried that this was all too much. He was doing really well and other than not wanting to eat much everything seemed normal. Then I went and jinxed us by saying that out loud to a few people. The rapid descent started on June 3rd at 12:30am when I heard him whining. Tonka has never whined a day in his life. Barked yes but whined-no. The poor guy had pooped all over his bedding and in trying to get away from it he had literally dragged his back end through it. I cleaned him up enough to stand him up and he immediately pulled me towards the shower. The only thing Tonka hates more than  water is being dirty. I got him into the shower and cleaned up the best I could with no rubber mats on the bottom to keep him from slipping. Usually I have time to setup the shower to bathe him with mats and his shampoo and towels close by. I got him out and had to lay him on the floor to go get towels and pick up his soiled bedding, he was not happy about that but I had no choice. I got down clean bedding  and towels and then lifted him and maneuvered him back onto them. the instant I started to lower him he had another episode of diarrhea It was now 1:20am I managed to get a pee pad under his hind end and lay him down on the plastic covered carpet while I picked up the bedding and put down clean stuff once again. I knew neither of us had the strength for the shower again so I put a towel over the pee pad and got a bucket of warm soapy water and a washcloth and set about cleaning him up. Once that was done I moved him back to his bedding and put a fresh pee pad under him and used the blow dryer to get him semi dry. He went again at 3:00am and at 4:15 and each time I repeated the clean up process. I emailed the oncology group as this was a chemo med day and I wanted them to know what was happening. His Dr. responded at 5:00 to withhold the chemo for the day and they would call me a little later.

Dr. Peterson called at 8:00 and I started him on metronidazole with instructions to not give him his Palladia and to see if he improved. We were good until 10:30 when the poor boy went yet again. It was my belief that there could not be anything left in him and I had to go to work for a few hours so I headed out. It wasn't long until that theory was proven wrong when my mom stopped in at 12:30 to check on him he went again but this time he also vomited. By the time Caitlin came for the day he was in bad shape. She sent me a text that his gums were tacky and he would not open his eyes for her so I rushed home. We put him in his stroller minus the wheels and handle and loaded him in the truck. I called the ER and told them we were coming in. His therapist Diana from CVSS met me at the truck and helped me carry him in. The next time I saw him they had drawn blood to test and had him on IV fluids.

Not a good start to our Chemotherapy experience...
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