Decision Made.

Jim and I, with the help of our primary vet, Dr. Becker, finally made a decision about Indiana's cancer. We consulted with more doctors than most people even know exist for pets: Two cardiologists, a nephrologist, an anaesthesiologist, and an oncologist.

The cardiologists and nephrologists were (tongue-in-cheek) not helpful, because they told us that Indiana basically is at no higher risk for surgery than any other twelve-and-a-half year old dog, heart- and kidney-wise. So that didn't help rule anything out.

The anaesthesiologist, while one of the nicest vets I've talked to, basically scared the crap out of me. It is, essentially, her job to think of everything and anything that can go wrong during surgery and take measures proactively to stop them. And I did tell her up front that I wanted to know exactly what we were looking at. She did ultimately say that Indiana was a candidate for surgery and she most likely would survive anaesthesia. But there were still some concerns from her perspective, which I understood. Putting a dog with chronic kidney disease, a right bundle branch block (an electrical issue in her heart which causes her heart to send out confusing messages), and a mass in her right atrium will give an anaesthesiologist pause. Moms and Dads too, apparently.

All of those health issues aside, Jim and I know undergoing anaesthesia is hard on any pet, but especially for older ones. Indiana was simply sedated several years ago, and it took her days to recover. Imagine what anaesthesia would do to her. While the possibility is likely remote, there is still a small chance that she could die on the operating table. I could have a live dog one morning, and in a manner of hours, she could be dead. That is a horrifying thought for me and Jim.

So we took the difficult step of asking the oncologist, "What if we don't do anything at all?" Only 5% of soft-tissue sarcomas metastasize systemically, meaning 95% of them pretty much grow in place. Given that Indiana's is on her back, it wouldn't impede breathing or walking. The biggest issue would be that once it grows too large (and who knows what too large is?), the mass would eventually split and ulcerate, leaving a big, gaping wound and opening her up to infection. But some soft-tissue sarcomas grow slowly, and others grow quickly. If we were lucky enough to have a slow-growing tumor, it might never grow big enough in what lifespan she has left to cause a problem. When the oncologist did the biopsy, she removed a lot of tissue, so the mass isn't even palpable right now. That's a good thing. She said we could wait to remove the mass when it grows back to its original size.

After consulting with all of these specialists, I met with Dr. Becker last week. She was amazed that the tumor was so small, given that it was biopsied about a month ago. You really can't even feel it, just a small scab. After talking over everything, we decided to wait. We won't be doing surgery right now. There is a possibility the tumor will never grow at all, or it might grow very slowly. If it ever gets back to its original size, we'll revisit our options at that point. But for now, it doesn't make sense to take her life in our hands to remove something that might not be a problem.

Jim and I feel good about this decision. It feels right. I worried I would feel like we were giving up on her, but I don't. I feel like we're giving her a good quality of life, and leaving her the heck alone. She doesn't even notice the tumor. We may be back in the same place in the future, having to make a choice about surgery, but for now, I know this is the right decision. For me, Jim, and for Indiana.