kali

Kali's Story

by Kathleen Pratt

Kali, our long-coated black and tan German Shepherd Dog, was 4 years old and in her prime in August 1996. That was when we noticed lumps under her jaw. We took her to the vet a few weeks later, because the lumps persisted, and he put her on antibiotics hoping it was an infection causing lymph node swelling. He did mention the nastier possibilities, but we all hoped not to have to think about lymphoma.

It was late September I believe, with the lumps still there, that we got serious. Our vet did a biopsy and the diagnosis came back - high-grade centro-blastic lymphoma/lymphosarcoma. The good news - highly responsive to chemotherapy. The bad news - Kali was going to die young no matter what we did.

After much research and worry, I took her up to Tufts Veterinary Hospital for their opinion and to explore experimental treatment options (at my vet's suggestion). All along, my vet encouraged me, took my thrice-daily phone calls, and told me that there were no wrong decisions. My husband was inclined to let Nature take its course; I wanted to try chemo, if Kali could tolerate it.

Throughout this time Kali was as vibrant as ever; at 4 she was in her full growth and most magnificent coat. Nobody could believe this dog was "Sick" - and she wasn't! We decided to give her a chance and in the last week of October began her regimen of Vincristine, Prednisone, Cytoxan, and Chlorambucil in rotating cycles. It was fairly demanding - the Vincristine was administered IV at the vet's - I used to drop her off Tuesday mornings. I gave her the various pills at home, always gloved and being very careful about dosage. Every week a CBC (blood count) was done. We were prepared to bail out at any time if Kali had bad reactions or began to get psycho going to the vet's; in other words, it was her decision whether to continue the treatment.

Two days after the first Vincristine drip the lumps were GONE. Not diminished, gone. The only side effects that appeared over time were a slight increase in weight from the Prednisone, and an increase in thirst, probably also from the drug. The vet had to use a catheter instead of a simple drip for the IV; she simply couldn't stay absolutely quiet for the time the IV took, and Vincristine going where it shouldn't can be disastrous. But she tolerated everything well and we learned to live in "dog time" - NOW - enjoying her, even as we tried to be prepared for anything in the future. Little things came up, like putting her on antibiotics after another dog wounded her play biting, because her immune system might not be up to snuff.

In March or April we noticed the lumps were back and switched from maintenance protocol to more aggressive treatment. The lumps diminished but didn't disappear and we knew it was a matter of time. By now it seemed to us that Kali was slowing down a bit, still lively and happy but with a little less stamina on our walks - or did we imagine it? My husband believed that Kali "knew" and maybe she did, but was that because we couldn't help being worried and sad in advance, and she read our minds? I don't know. We tried to live as usual and not worry until we had something to worry about. I had done my homework and I knew that the end game might be unbearable for all of us, but I tried not to dwell on it.

The end, when it came, was "easy". The last Friday in June 1997, Kali and I went for our morning walk before work and she was fine. When I came home at noon she was clearly sick, groggy and shaky on her legs. I called my husband and we dithered a bit, but somehow it didn't matter what was wrong, whether it was "fixable" - Kali was telling us it was time. She was not in pain, so the vet agreed to come to the house after hours and we waited together out on the lawn through that long afternoon. Sometimes she was alert, other times drifting in and out. My husband prepared her grave in the woods out back. When the vet arrived, Kali got up to alert me, then greet him - a Shepherd to the end.

This is a long story and one person's experience. I think it's a success story. Kali was never sick, never had symptoms from the disease, and never had any bad reactions to the drugs. If we had jumped on it sooner, maybe she'd still be with us this year. As it was we spent around $1800 (including consultation and biopsy - the drugs were around $1500) and quite a bit of effort (which quickly became routine) to give her 8 months of high-quality time and us the pleasure of her company. We were lucky to be able to spend that money, time and effort - I work part-time, my husband is self-employed, we had a good year financially - it would not be possible for everyone and not every animal would tolerate it. There are no wrong decisions, as my vet said. The end came when Kali's kidneys failed, whether from hypercalcemia of malignancy or from the drugs, or both, it doesn't matter. It would have been swift even if we hadn't called the vet over to put her to rest. We were very lucky. I would do it over, or at least give it a try, if Heaven forbid I ever have to make this decision again, though I know that not all outcomes are so good.

To contact Kathleen with questions, send email to: pracon@cape.com