And So It Begins

It was April 2012. I was meeting a new client who had just brought home her 8-week-old golden retriever puppy, Remington, from a breeder the day before. Because she wanted Remington to have the best start in life, she contacted us for 2 daily midday dog walks while she was at work all day to help him with transitioning from his litter to her home, housebreaking, and teaching Remington things a well-mannered puppy needed to know as he grew.

I was most delighted I’d get to spend at least an hour daily with this adorable nugget of a golden fluffball who was too busy exploring his new home during our meeting to pay much attention to me. Years later, we’d joke about how Remi basically blew me off the 1^st time we met and played very hard to get to make me fall madly in love with him. If that was his plan, it worked!

During that 1^st meeting, I never could have imagined the scenarios that would unfold to make him mine.

The next day, Remington and I began our midday walks. From the start, he was pretty much the perfect puppy. He was not only the cutest puppy in the history of puppies, he impressed me immediately as highly intelligent from our 1^st walk – grasping new tasks almost instantly and even cracking his puzzle toys more or less on the 1^st try. I was thankful he seemed inclined to use his smarts for good and not evil!

He was as sweet as he was smart. Chockful of curiosity and fascination, a joyful glimmer radiated from his bright eyes as he explored the world around him.  He greeted everyone with his ambassadorial nature kissing anyone willing to accept his abundance of tongue slaps. His slightest bit of puppy deviance was comical. He’d grab his leash while we were out on a walk and tug while playfully growling refusing to drop the leash from his jaws. A few toys and light grade dog beds bought the farm under his teething era. But, that was pretty much it as far as puppy misbehaviour.

He was perfect - truly a ‘golden boy.’

I knew I was falling in love with him more every day and looked forward to seeing him daily. I missed him terribly on weekends. It was torture for me to be without him for an entire week if his mom took a vacation! I really couldn’t get enough of him and found it nearly impossible to tear myself away from this boy.

Because his mom wasn’t really comfy taking him out into the world beyond his neighborhood walks because he was a handful for her, I offered to take him on little adventures on weekends. I could see his curiosity blossoming more and more as well as his appetite for exploration. He was dying to get out into the world beyond his neighborhood borders. He wanted more. He needed more. And, I really wanted to give him the chance to expand his horizons.

Luckily, his mom kindly agreed to let me borrow him so Remington could enjoy some field trips. He and I visited places together like Middleburg, Annapolis, and various area parks like Mason Neck State Park, Burke Lake, Conway Robinson State Forest and Cabell’s Mill. He was in heaven when on an adventure. The more he ventured out, the more he wanted this as a regular part of his world. And, what Remington wanted, Remington got.

I was always thrilled to have him stay with me whenever his mom was away because it meant more Remi time and more opportunity to enjoy adventure together.

I had planned on a Christmas 2014 vacation to Hilton Head Island, South Carolina but quite honestly, I was having a hard time thinking about being without Remington for almost 2 weeks. I knew Remi would love it and was ready for a longer road trip after months of short trips locally. His mom had planned on a few days away with family so this was the perfect opportunity to give Remi his first taste of the beach and would allow me to be able to take care of him for her while she was away. I would just take him with me if she was ok with it.

I remember being afraid to ask his mom if she would give Remi permission to go with me to the beach and was over the moon when she said: “Sure, if you don’t mind handling Remi and all of his problems” referring to his epilepsy discovered just a year before.

I will forever remember our first walk from the rented house to the sea. It was almost as if he followed the smell of the sea tugging me there knowing something very exciting awaited him. Upon arrival in the sand, he gave me the ultimate look of “WOW, so THIS is what you’ve been talking about!”.

He was as dazzled with the beach as I was by him. He pulled out all the stops – that deviant leash tug puppy dance had become his adult dog happy dance. To this day, anytime we visit a beach or when he’s beside himself with joy, he gives me ‘that look’ and grabs onto his leash to playfully tug and do his celebratory dance of absolute delight. Every time I see that dance, I too celebrate his joy and the fact he’s still here and healthy enough to enjoy life so fully despite the fact he has a very trying case of epilepsy that almost killed him but made him mine.

About a year prior to that 1^st beach trip, I arrived for his midday in October 2013 to find him disoriented and acting very strangely. There was a huge pool of pee on the floor in the kitchen where he was gated as a young boy. It was particularly odd since, even as a young pup, he never had accidents. He was very clingy, dizzy, clumsy and just not himself. I called his mom at work and she came home to take him to the vet. Neither of us had any idea what was going on with him and were very scared.

Because nothing else seemed off with his health, his vet suspected he’d had a seizure. We were dumbfounded as he’d always seemed normal and we had not picked up on any signs associated with the onset of seizures. Of course, at that point, we didn’t yet know the signs of the onset of a seizure. We suspected I happened to walk in on him that day after his very 1st grand mal seizure. It was absolutely terrifying to see him so off and have no idea what was wrong.

In the next few days, he’d have more seizures. At that point, his vet then prescribed an anticonvulsant. Usually, anticonvulsants are not prescribed until the dog has experienced at least 3 witnessed seizures to rule out a fluke occurrence. Unfortunately, that 1^st seizure was not a fluke. This would come to be Remington’s life.

More seizures soon occurred. Remi became an overnight regular at the emergency vet after suffering bouts of cluster seizures experienced despite taking his anticonvulsant as prescribed.

Something was very wrong. Remi’s primary vet recommended a neurology consult to further delve into cause. Remington soon had his 1^st neurology consult and an MRI to rule out a possible brain tumor.

Luckily, Remington’s MRI did not show a brain tumor. He was diagnosed with primary idiopathic epilepsy which basically means epilepsy with no known cause. He was having seizures from an unknown cause although usually genetics are suspected. No surprise as it’s quite common in golden retrievers.

At this point, his mom was quite overwhelmed as anyone would be when their dog was given this diagnosis along with all the scary possibilities like how he could seize to death or suffer severe brain damage during cluster seizures. But, I assured her she did not have to handle this alone. I loved him as if he were my own dog and would work with her to help manage his condition as it was definitely more than a 1 person job. He took a village, as it is said.

I was fully invested in Remington before his diagnosis and became all the more invested in him once he was diagnosed. I was hopeful that between his 1^st mom and me, we could get him on the right track towards a normal life.

We had become friends and Remi became a group effort especially as Remington was considered a difficult to control epileptic. His condition would prove extremely challenging as he was not easily regulated with medication as some cases are. I’d had a few other epileptic clients who were lucky to only suffer 1 seizure every 6 months. This wouldn’t be Remi’s luck.

While we were relieved Remington did not have a brain tumor, controlling his seizures would prove very challenging to downright impossible at times. Often, it felt hopeless. Soon after his initial diagnosis, the cluster seizures kicked in, despite the addition of other meds, and Remington would have strong grand mal after strong grand mal and have to be rushed to the ER repeatedly.

The goal was to find a drug mix that would keep Remington’s brain happy and controlled so he could lead a normal life. He was not even yet 2 years old. The brain is tricky and finding a mix to control Remi’s seizures was very difficult. There were times we weren’t sure we’d ever figure out a mix that could control his seizures and achieve quality of life.

His neurologist would add a drug to his mix that would seem to stabilize his brain. Then, his brain would break through it. Lots of tweaking later, he’d reach equilibrium and maintain for a few weeks only to seize again.

The thing with epilepsy is it’s not finite in the way you can fix a leak by replacing a roof and be done with it.  An epileptic brain is constantly evolving in a way that what works today or has worked for months may all of a sudden stop working. Despite following very strict dosing protocols with him getting the right meds at the right times daily, he still was having cluster seizures and risking brain damage.

We started to wonder if he’d ever stabilize and be worn down emotionally with worry and then he would stabilize. He’d still have a grand mal seizure every 2-3 weeks but the severity was less and his recovery was faster. Overall, he was a very happy dog and able to enjoy things normal dogs enjoy. Medically, epilepsy is considered controlled if there is less than a seizure per month. In standard terms, Remington’s seizures would not be considered controlled with a seizure every 2-3 weeks but his neurologist explained that was controlled for Remington. He didn’t follow the rules and was not considered a typical epileptic.

With such conditions, you make a choice. Do you keep the dog drugged out of his mind to have higher seizure control or do you find a happy medium and manage with the idea they may have a seizure more often but will overall have a better quality of life and be lucid enough to enjoy his life?

His mom and I agreed the happy medium was the best approach for this happy dog to enjoy his life while supporting him through the rough seizure patches. Keeping him drugged out of his mind was not an option because that would be no life for him.

Occasionally he’d get knocked off balance thanks to his active epileptic brain. He’d even gone 6 entire months without having a seizure before starting down a trying road in late spring/early summer of 2015 when his seizures began to increase in frequency, duration and intensity. He’d had another MRI to rule out the possibility that a brain tumor had formed.

No brain tumor. Just idiopathic epilepsy being difficult to control. He was seizing frequently, spending a lot of time in the ER and overall could not settle. His neurologist tweaked his meds yet again. He stabilized again but then his brain flared. By early summer 2015, again, he was back to having frequent strong seizures and scaring all of us into thinking he may end up seizing to death at this rate.

His neurologist suggested trying potassium bromide(KBr) which is usually a very effective drug for seizure control with fewer side effects than other anticonvulsants.

We hoped with the addition of KBr in August 2015, Remington would finally stabilize. The introduction of this drug was difficult as it completely wiped out his balance. Remington had grown to be about 5 feet tall standing with long legs. He was SO tall I had dubbed him The Baby Giraffe years before. So, mobility was particularly difficult on the loading dosage for a long and lanky boy like Remi. His brain seemed to stabilize and we were assured his mobility would return once he acclimated to the drug. That never happened.

Remington’s in Serious Medical Trouble

Instead, within about 2-3 weeks after starting this drug, he was also developing very severe gastrointestinal problems that had him up nights needing to go out repeatedly while his stomach was on fire. At first, it was not apparent starting out with panting and pacing mistaken for an unsettled brain. It progressed to soft poop that would soon become explosive poop multiple times daily. His mom said he would be awake during the night smacking his lips and pacing. Pacing was something he would do when his brain wasn’t settled and a seizure was imminent. At first, she suspected the pacing was his brain when, in fact, it was actually a sign of the gastrointestinal distress.

She was reluctant to take him off the KBr due to the seizure control we achieved but, to me, it was obvious he was not tolerating this medication well. He’d not experienced these symptoms until the addition of the KBr. Only about 5% of those who take KBr suffer GI issues but Remington wasn’t that lucky.

His brain remained stable but now he had other worsening problems. His stomach was constantly gurgling and I could see he was uncomfortable during our midday visits. I’d done some research on KBr and started to suspect it was causing the problems we were seeing.

I encouraged his mom to take him to see a primary care vet I’d known for years. I’d worked with her on a few difficult cases over the years and knew if anyone could figure this out, she could. I offered to go with them because Remington was so sick and weak. I also knew his mom was overwhelmed and probably could use some support at the vet given how sick this poor dog was. He’d spent the last few days just lying on me during our midday visits. I knew he was miserably ill and he needed me as much as I needed to be there for him.

I presented the vet with the information I’d found on KBr and she agreed it was likely the KBr causing the GI distress since that was the only new thing introduced into his system. However, when she examined him, she said she’d never felt such an inflamed colon and feared permanent damage had been done to his system. I’d known her for years and well knew her expressions so was chilled to the bone when her face conveyed how much trouble Remington was in as she explained he could very well have permanent damage done that may claim his life. He had a 50/50 chance of recovering from this.

All of us feared Remington would never recover. He was a mess. He’d lost about 5lbs in a week and probably around 10lbs since this ordeal began. He’d always been on the skinny side so really could not spare to lose 10lbs. Even his fur had started to fall out. Goldens have a significant undercoat and he completely lost his undercoat.

He was not the vibrant, enthusiastic dog I knew as Remington. It broke my heart and I feared for his life. KBr had acted like poison for what it was doing to him overall.

Remington’s Road to Recovery

The vet said what he needed most now was basically what would be considered around-the-clock consistent critical care. This was absolutely essential if he had any chance at recovery and recovery was not guaranteed given his current condition. This was not a tummy ache. He was at risk for death. That scared the hell out of all of us!

Because he was so sick and his 1^st mom had to be able to sleep through the night to be able to go to work every day, I offered to take Remington home and rehab him. Since I own this business, my schedule was much more flexible than hers and since specialized care was my area of expertise, it made the most sense for Remington to come live with me with the hope I could get him well again. I asked his mom to trust me. Just let me do what I do and I promised her I would do everything I could to get him back on his paws again. I was determined I was going to get Remington healthy again no matter what.

Remington packed his stuff up and came home with me to start his recovery in late Sept 2015.

My first act: stop the potassium bromide which thankfully was a drug that could be stopped cold turkey.

As soon as I stopped the KBr, I began to see slow but encouraging improvement for his GI system but not for his brain that had stabilized on the KBr. So, removing the KBr from his regimen triggered a series of seizures. Again, he underwent a medication tweak to keep his brain happy and had to eat a special diet to try to help heal his gut. We had to work through the seizures that would result with stopping the KBr but soon got that sorted out with his other meds tweaked to account for the removal of KBr.

Slowly, I saw progress daily. By the time, he clearly ‘told’ me he was sick of eating his bland special prescriptive dog food with 1 of his very telling looks of disgust, I took that as a sign of hope. Remington speaks volumes with just about every look. I would get these looks that I read as: “Oh, not that crap again. Where’s my usual fare??” Remi was a foodie so the same old bland stuff at every meal was not a big hit once he was feeling better. This look of disgust was a fantastic sign he was getting better.

By early October, he was becoming more Remington. His brain was stabilized as we’d fallen into a routine together and his GI system was functioning better daily. No more tummy gurgles or diarrhea!

We maintained the boring prescriptive food. I would apologize to him promising we were almost ready to try regular food again because I’m convinced he does understand me. He was playful again and his vivacious personality had returned. I knew we weren’t yet out of the woods but for the first time in over a month, I felt more confident this golden boy would pull through this horrifying experience.

At his next check-up, his vet was shocked by how well he appeared as he walked into the room and was pleasantly surprised to feel that he was, indeed, healing. He even gained back some weight and put on some muscle. His fur was growing back in. She recommended we continue doing what we were doing and Remi continued to get better and better.

By mid-November, he was well enough recovered to go home. Remington had made a full and rather miraculous recovery! He acted and looked healthy again!

However, it was nearly Thanksgiving and he always stayed with me over Thanksgiving so his mom could travel to be with family for the holiday. I’d also planned on another Christmas trip to Hilton Head and since Remington seemed to be on the mend and quite healthy by Thanksgiving, I asked to take him to the beach for much needed R&R for us both. Dog knows he earned some fun after the last several months of hell he lived through.

His mom and I agreed that I’d bring him home in January 2016 after we returned from our beach trip. We felt it best to let him stay with me for the duration rather than bouncing him back and forth since he’d be with me for most of the rest of 2015 over the 2 holidays.

Remington was more than ready to go to the beach. He’d learned what the big red bag meant from the previous year’s beach adventure. He was onto me and lit up when he saw me packing that bag the week before Christmas. I can’t even express the joy I felt to see him light up knowing he was almost dead a few months before this.

He hopped into the car with his BFF toy Rafferty, the 2 foot tall Tuffy giraffe our ‘baby giraffe’ loved to take with him everywhere. He conveyed his ‘Let’s go!’ attitude and settled in for the long ride to Hilton Head Island. He even popped up in the backseat when we reached Exit 8 on I-95 because the boy genius knew exactly where he was. HIS island and HIS beach!

He relaxed on the deck and did long beach strolls like a champ. We’d run into people we’d met the year before and they were shocked to hear about his recent ordeal because he looked and acted so well. Remington had beaten the odds with a full recovery and was ready to start living again.

It was the best Christmas of my life because I had something enormous to celebrate: Remington was healed and his brain was happy. His seizures had subsided and finally the entire Remington was stable and healthy again. I’d fight back tears of joy as we’d stroll that beach because I really wasn’t sure just months before that he’d still be with me to make this trip.

He was angry when I insisted we return to Northern Virginia as he never really understood why we ever leave Hilton Head Island in that way dogs just don’t understand human stuff or the way dogs are simply smarter than we are and know where life is better. I knew he was right and this was a better place to be but he also didn’t exactly offer to get a job so we could stay there!

Remington Refuses to Go Home

It was now January 2016 and it was time for Remington to go home to his mom. He was now around 95lbs of a muscular dynamo and the picture of health – truly a furry blonde powerhouse all around.

I packed him up and drove him home where he went nuts to see his 1^st mom. However, he was not happy when it became apparent I was leaving him there. It took some diversion to sneak out of the house because he would come and glue himself to me when he got wind that I was leaving. I promised I’d see him on Monday for his usual midday walks and tried to hide how hard it was for me to leave him after how tightly we’d bonded over the last few months through his ordeal.

I got home and started getting texts from his mom that he was moping and would not settle after I left him there. She had started a new job and was now working mostly from home and hoped that having her company all day would make him happier and he’d still have his midday walks with me too.

I fully expected he just needed time to settle back into regular life like all of us do after we return home from a vacation. Unfortunately, that was not the case.

On Monday, his mom texted to tell me he had not slept but was up for most of the nights over the weekend unsettled as if looking for me. I figured once I saw him at midday, he’d get that we were back to normal life and would settle down again. Our middays were normal but he protested me leaving him in a way it was almost impossible to get out the door. She’d be working downstairs and he’d refuse to go downstairs in the morning as she said it seemed he was waiting for me.

Monday and Tuesday nights, his mom said: Again, no sleep. He’s pacing and panting. She’d first thought he was just gearing up for a seizure but suspected this was more about him being away from me.

Same thing Wednesday, Thursday and Friday nights. That also meant his mom got no sleep!

By Wednesday midday, I’d hold him after our walk to try to get him to sleep. He’d lie on me and doze off and even if I sat with him for an hour, it wasn’t enough to replace the sleep he needed and missed. Sleep is critical for an epileptic to keep the brain stable so this lack of sleep was concerning and would definitely result in seizures from lack of proper rest.

A few days later, as expected, the seizures began most likely resulting from his lack of sleep and anxiety that seemed to be tied to being away from me. He was still not sleeping unless I was holding him and since I wasn’t living with him, he wasn’t sleeping much because I wasn’t there holding him.

It seemed as if enduring his KBr ordeal together bonded us together more tightly than I realized.

I offered to take him for the weekend hoping he’d settle and to let his mom catch up on her sleep. His routine is quite stringent so he gets meds on time so you can’t exactly opt to sleep in. We’d hoped maybe we could gradually acclimate him back to his previous life. He did well with me over the weekend and acted normally – slept normally, no seizures, etc.

She opted to let him stay with me through January to see if his seizures would stop. We were trying to determine if this was new brain activity or simply a result of an environmental change. His neurologist had said we could increase his medication but he was taking so much medication already, adding to it was the last thing we wanted to do especially given what his system went through months earlier.

The rest of January 2016 was smooth. We concluded through what we jokingly called our own ‘clinical trial’ that he didn’t really need more medication. He wasn’t happy about going home and being away from me and that was what was causing the anxiety, inability to sleep and resulting seizures.

The plan was to try to take him back home in early February. I had a previous commitment to stay with a dog who had severe behavioral issues. No one else could take care of her and her parents were going on vacation so Remington would have to go home and Remington would have to go home at some point because he wasn’t my dog as much as I wished he were. We really thought it was just a matter of him growing accustomed to being home again. Not the case at all, we’d soon learn.

Same drill but worse. I took him home in February and it was a disaster as we feared it would be.

He refused to sleep, still clung to me but added screaming his head off and panic digging on the rug by the front door at home when I would leave. He even shot out the door as I left after 1 of his midday visits. He’d never run out the door but he was desperate to leave with me.

I’d suggested that perhaps I stop doing middays so we didn’t have this level of panic when I left every day but the only time he was sleeping was when I was there at midday holding him. It would KILL me not to see him but if I had to stay away so he wouldn’t freak out every time I left, I was willing to do what I had to do to let him settle back into his home.

His mom also did not want to deny Remington time with me so opted to continue midday walks but after that week of him being panic stricken as I’d leave and refusing to sleep with more seizures, we knew we had to do something. His brain could not take this situation as it were. I’d be in tears as I left him because I felt like I was abandoning him – at least in his mind – when I’d have to leave him at his home where he belonged. I felt guilty that somehow I had caused this dog to attach himself to me so deeply that he did not want to go back to his original home. I felt bad for how his 1^st mom must have felt rejected by him because he refused to settle back in with her.

We’d discussed how to handle this. I remember his 1^st mom saying to me: “He needs to learn to live at home.” She also joked: “Maybe you’ll just have to adopt him” although I knew she loved him and really wanted him to return to life with her as it once had been before he got so sick.

I remember feeling distraught because somehow I had to make her understand that may never happen. I was worried we’d lose Remington to seizures if we didn’t sort out the best plan to stabilize his brain again and that seemed to be an address change.

I feared Remington had already decided we were supposed to be together after what we’d been through together with his recovery. In a way, I thought he’d made his choice and because he was an epileptic, stressing him out by forcing him to be somewhere he didn’t want to be would be catastrophic. The last thing we wanted was for him to end up in status epilepticus which is a continuous seizure that usually ends in death.

His neurologist said we could add more drugs but I knew that would mean a life doped out of his mind just so he could live in his 1^st home and tolerate the separation.  Neither his mom nor I wanted a doped out life for Remington because that would be no life.

After I finished my week of overnights in mid-February, his 1^st mom asked if I could take him again because they’d both been up the entire week aside from the time he was napping on me during our middays.

We’d continue to discuss possible solutions but we also were both curious if the seizures would stop once he was back with me at home as they did in January during our 1^st ‘clinical trial.’

Sure enough, he fell back into a comfortable routine with me at my house. He walked in the door as if he was where he felt at home now. This persisted. We tried it for the month and he remained stable and returned to his normal happy self I’d seen before taking him home in January.

I knew it was now time to have a tough discussion with his 1^st mom who also recognized we had 2 choices:

1. Drug Remington out of his mind so he could live with her.
2. Remington came to live with me permanently.

It was both an easy and difficult decision for her. Hard to let Remington go but she knew the only way he’d have a life without more drugs was if I adopted him. She also had expressed how hard it was for her to handle the level of care he required and how freaked out she was with his seizures. It was an impossible situation that required a viable solution.

Remington’s Change of Address

But, Remington had made his decision. She asked if I was willing to adopt him permanently and of course, I was more than willing all while encouraging her to remain part of Remington’s life which would be easy since we’d become friends over the years too.

I still felt horrible as if I were taking this dog away from his mom but given his serious medical condition, it was really the only right choice to be made for him to have a chance at living the full life he enjoys today. I struggled with the idea of taking him away from his mom but our vets assured me – this was what had to happen for him to have a chance at a healthy life.

He has only gotten better since he moved in with me permanently in February 2016. He stabilized almost immediately once he caught up on his sleep and had leveled off to a seizure just about once per month which is really good for him.

He had another rough bout with clusters of focal/partial seizures in September 2017 that sent him to the ER for the 1^st time in years. His neurologist suggested allergies could be a driving factor as he was also licking his paws a lot but who knew allergies could have such an impact on his brain? He’d been on allergy meds for years since he had the typical golden allergies but this was something else. Even with a clean diet, the boy had a serious case of allergies.

I made an appointment for him at a dermatologist who would diagnose Remi’s itchy feet as canine Malassezia dermatitis and prescribed anti-fungal meds to manage it. As usual, it wasn’t that simple. We learned he needed daily anti-fungals for maintenance rather than just in response to itchy feet on occasion. Without daily meds, the problem would slowly build until it was messing with his brain. Like most things, Remi’s version of this was more severe than average. But, daily dosages have kept the feet controlled and prevented frequent flare-ups of focal seizures. Once in a while he has a flare up when allergens are off the charts but overall, that too is now managed.

We do say Remington likes to keep us guessing though! He had another surprise for me.

The Osteosarcoma Scare

In February 2018, he had an osteosarcoma scare – or what I call the scare of my lifetime. He had been having cluster seizures out of the blue and the vet tech at his neurologist just happened to discover a lump on his paw as she shaved it for an IV. We were devastated because the lump was discovered on his paw in a place that often indicates osteosarcoma in larger breeds.

He immediately had scans to determine if the suspected cancer had already spread to his lungs but his lungs were clear. Osteosarcoma usually quickly metastasizes to the lungs so we had hoped he had time because we were not seeing anything in his lungs. He also was not showing any typical symptoms of osteosarcoma. He wasn’t lame. He wasn’t limping. It didn’t make any sense. But every doctor strongly suspected and feared osteosarcoma.

I never expected that was how his neurologist appointment would go that day figured he just needed another medication tweak after being on the same mix of meds for years.

The 1^st oncologist appointment sent me looking for another oncologist as the 1^st oncologist -in a practice I would NEVER take a pet rock to after that experience- wanted to amputate his leg before even confirming it really was osteosarcoma because ‘they see a lot of these.’ She was quite confident and casual about her treatment recommendations after spending an entire 5 minutes pushing amputation without even laying a finger on Remington. There was no way I was agreeing to amputation without definitive confirmation that it was necessary.

Even with amputation, you’re not curing your dog of osteosarcoma so that is only a measure to hopefully buy some time. Because amputation was not curative, I was in no rush to rush into something that may not be necessary and sought another opinion.

I made an appointment with a radiation oncologist to discuss the overall diagnosis, options and stereotactic radiation that was presented as the alternative to amputation. Thankfully, this oncologist was willing to spend the time to discuss all of our options and instead of pushing amputation or radiation recommended a surgical consultation to get a specialty surgeon’s opinion on this horrific diagnosis. Thank Dog for her because her recommendation led us down a very different road to a very different destination than suggested by the 1^st oncologist.

A few days later, we met with the surgical specialist who recommended a bone biopsy to confirm osteosarcoma rather than being gung-ho with an extreme amputation. I was distraught with even the idea that Remi could soon be dead from a cancer with a hopeless prognosis. The idea of him losing a leg only to die from osteosarcoma anyway was almost equally distressing. He wasn’t exactly a small dog at 5 feet tall and around 98lbs. No one was cutting his leg off unless I had proof it was necessary.

I agreed the bone biopsy was necessary and in the meantime began researching osteosarcoma vaccines offered at some vet schools. Remington underwent an osteotomy to remove the part of the bone where the lesion was. That would also serve as our biopsy sample. Luckily, that was not a weight bearing bone so with removing a small piece of it, his ability to walk would not be impacted at all once he healed from the surgery.

While suspected to be cancer, it would have had to come out regardless due to the inflammation of that piece of bone. But, it was much better for him to lose a small piece of bone in a non-weight bearing bone than his entire leg especially because he didn’t have cancer!

After 2 grueling months of thinking I was going to lose this incredible dog at only 6 years old no matter what given the death sentence osteosarcoma is, 2 weeks after his surgery, his surgical biopsy came back clear. There was NO cancer!!

I almost couldn’t believe we got so lucky. At the same time, all I could think was: “What if I let them cut his leg off only to learn he didn’t have cancer?” To this day, I get sick actively thinking of what may have been had mama not been a hardhead.

We concluded he may have had a slight bone fracture caused by 1 of his very early very violent seizures in his 1^st home. The lesion may have formed as that injured bone remodeled. He just never showed it in his gait for us to ever notice the slight injury. The turn of events was almost unfathomable.

Remi recovered beautifully from his osteotomy complete with attitude annoyed that I wouldn’t let him walk far or run on that leg for many months to come. His biggest thrill was using his bandaged leg to bat around the toys I refused to toss while shooting me a look of defiance! I had hoped that was our last bit of medical drama but that was not the case.

And Now Liver Cancer

In February 2019 shortly after his 7^th birthday, we discovered liver masses on an ultrasound performed after his primary vet thought she felt something during his annual exam. More specialized ultrasounds would confirm there were several masses in his liver that may or may not be something of concern. We monitored for growth with a few more ultrasounds over the next few months. While at first the largest mass didn’t seem to be growing and I stupidly breathed a sigh of relief, the 3^rd ultrasound a few months later, would show growth as well as elevated liver levels in his bloodwork well beyond what we’d ever seen before. It was time to delve deeper.

A fine needle aspirate showed a good possibility of cancer but we couldn’t know exactly what it was unless we did a surgical biopsy. We had to identify the type to match it to the most effective treatment.

After a CT, Remi had a surgical consult and we agreed to an exploratory surgery and biopsy with the idea of removing the mass IF the surgeon felt he could do so safely without a huge hemorrhage risk. If not, I wanted him to get out of there and we’d go at this a different way. He agreed that was the wisest approach. We were hopeful for a successful liver lobectomy as the most effective treatment is to be able to remove the mass which would be curative.

Unfortunately, during surgery, Remi’s surgeon discovered the large mass attached to his diaphragm which would make it impossible to remove without risking Remington’s life. Remi could bleed to death and that was not a risk I was willing to take. Instead, he was able to remove another 2 masses and got samples of all to later confirm the large mass is low-grade hepatocellular carcinoma or primary liver cancer.

Treatment options are complex at this point too. Because this is a slow-growing cancer, it doesn’t respond well to chemotherapy. There is promise in a procedure called chemoembolization that cuts off blood supply to the tumor. However, that too is risky – not as risky as removing the mass but risky in its own way especially when you consider Remi’s an epileptic which makes any surgical procedure involving anesthesia high risk. Remi’s tumor location is not exactly ideal to get the most from chemoembolization either as per his CT and 1^st consult at the University of Pennsylvania in Dec 2019. So, the risk may not give us the ideal return.

But, since that is our best hope, we’d scheduled chemoembolization in January 2020 only to have Remi seize in the hotel the night before. Remi’s timing always impeccable!

We opted to postpone the procedure until his brain stabilized as not to add risk to an already risky procedure. We’d hoped to try again in March but then COVID-19 happened so we now await next steps.

In the meantime, to give Remington the best chance in this fight, I’m supporting him with cancer-fighting supplements and a homecooked diet I specifically formulated to boost his immune system. Since we now know there is such a strong correlation between cancer and food, Remington’s diet is his front line defense.  Remington is not yet showing any signs of illness from the liver cancer so I’m hopeful my big strong boy will be with me for a long time to come.

His Royal Fouziness’ Determination

Resilient Remington is most determined to keep living his life to the fullest. Now at the age of 8, he still rolls like a big puppy kicking his long legs in the air like he just doesn’t care at least 3 times daily. He remains a glutton for adventure and just about anything I’m eating. I don’t dare say the word ‘BEACH’ without being able to take him there. It’s a bigger word of excitement for him than TREAT.

He is the happiest dog most people have ever met despite the cards he’s been dealt. To say he lives a charmed life is the understatement of the century but I’m honored to be able to serve in his royal court.

Very sadly, last summer, amidst his liver cancer diagnosis, his 1^st mom passed away very unexpectedly. She and I had just been talking about how many times he’s scared us to death yet has this incredible strength to plow through what he’s facing as if there’s nothing going on with him.

During what would be our last conversation, I randomly had said: “I don’t know how you knew to pick this dog from all the puppies in his litter but somehow you chose the most perfect puppy. He is the best gift anyone has ever given me so thank you for giving him a chance at a life.” I had no idea just days later I’d learn of her death but I would hope she knew Remington would always be cared for in the best way possible for the rest of his life.

He is not only loved but worshipped for being the most extraordinary creature I’ve ever met in my entire life. I thank him every day for choosing me to be his mama and promise him that nothing or no one will ever come before him as long as he graces my life with his presence. I tell him he is the best someone ever to happen to me, and I mean it!

I truly have no idea how I got so lucky to have Remington wander into my life and adopt me but hopefully he knows just how much I love him and that will keep this once-in-a-lifetime dog going strong for several years to come.