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Nero's Cancer

(click any of the pictures for larger versions)

Last Updated: September 20, 2000 (see bottom of page for newest material)

It was Tuesday, April 25, 2000. I noticed Nero had developed a slight limp in his right front leg. Normally this means he has ripped a toenail, or strained a muscle. I checked out his foot, found no injuries, and figured it was a slight strain.

The next day, it was worse. I sat down and examined his foot again, more thoroughly. Again, I found nothing.

Thursday, it was worse yet again. I did an intense examination of his foot, then moved up his leg - and that's when I found it. A fair-sized lump in the lowest joint of his right front leg. As soon as I found it, I felt the dread.

I called our vet. He saw us immediately. I saw his face drop when he examined Nero, and I could tell he knew as well. He took Nero off immediately to do a couple of radiographs. When he came back, the tumor was easily visible. Our hearts sank. What does it mean for Nero, we wondered? Our vet gave us our options, but we could see the terrible disappointment in his face - he loves Nero as well. We were amazed that the cancer had come on so quickly - it had been only four days before that we had had Nero out running in the fields, doing what he loved to do. There was no sign of pain or limping at that stage.

We had to decide what we were going to do. Our vet took a biopsy to confirm the diagnosis, and we went home to talk about it. Our initial thoughts were that no matter what, we did not want Nero to suffer any pain. Bone cancer is extremely painful, and it was quite obvious that it was hurting him - he was no longer putting any weight on the affected leg.

We decided that we would have our vet treat the leg with radiotherapy to kill the nerve endings, thus eliminating the pain. We did not want to amputate the leg, as we thought it would severely affect Nero's everyday life.

The biopsy came back positive for osteosarcoma, which was no surprise. In the meantime, we did a great deal of research about bone cancer, talking to Deerhound people around the world, and searching the Internet for every morsel of relevant information. We also talked to the vets at Ontario Veterinary College, part of Guelph University. OVC is the oldest, and one of the premier veterinary schools in North America, and it produces some of the finest veterinarians in the world, ours included. The vets there had us consider amputation and chemotherapy, something we hadn't before wanted to do. After talking with them, and doing a fair bit more research on our own, we decided that this was the route to go - it eliminated the pain, and gave Nero the best chance for the longest survival. We did consider limb sparing, where bone from a donor dog is used to replace the cancerous bone, but decided against it for two reasons - first, historically it did not do well on Deerhounds, and second, there are few donor dogs large enough to donate bone to Nero. (addendum: We later found out that the donor dog is actually sacrificed in order to supply the bone that is used - something that we would never want to do! Had we known this at the time, we would never have even considered it as an option.)

Bone cancer, or Osteosarcoma, metastasizes very early, travelling through the bloodstream into the lungs. By the time you have detected the primary tumor, it is already in the lungs. By amputating Nero's leg, we could stop the production and spread of any more tumor cells and eliminate the source of his pain. With chemotherapy, we could hold off the lung metastasization for as long as possible.

Nero's workup was done at OVC on Thursday, May 18th. They did blood tests and other tests to make sure he would be able to handle the surgery. On Friday the 19th, the amputation surgery was performed. Nero came through it like a champ. On Saturday, despite his IV and urine catheter, he stood up and wanted to go out. Sunday he improved even more, and his IV and catheter were removed. On Monday, we went to pick him up. He was clothed in a large, pink (!) bandage, which, in true Nero fashion, was already starting to peel off. We fastened it securely with our old Nero standby, duct tape. Nero was quite thrilled to see us, with his tail wagging and a big smile. He didn't seem to have any problem at all getting around on three legs, although he had already had a couple of weeks of practice not using his bad leg, as it hurt him too much.

He didn't seem to be in any pain, with the exception of when he would first get up after sleeping for a while. He would stand up and scream for a few seconds, and would then stop as if nothing had happened. Worried, we called our vet to ask why this was happening, and if we could give him some painkillers. He said that it would happen for a couple of days, and it was due to Nero trying to use the leg which was no longer there. Once he learned to not use the old muscles (which had been sutured together under the skin), the pain would disappear.

He was right. On Wednesday, five days after his surgery, there was no evidence of pain at all, and Nero was improving by the hour. He seemed to be utterly relieved to be pain free once again, after having endured several weeks of intense pain from his tumor. His personality came back, and once again he wanted to go and play outside with Melly (our rescue Greyhound).

A few days later, Nero had a visit from our vet, who changed his bandage. Nero was getting around quite well, up and down stairs, and was in generally great spirits.

On June 2nd, Nero went back to OVC. They removed his sutures and gave him his first course of chemotherapy, a drug called carboplatin. This drug is similar to cisplatin, but does not require the excessive hydration that cisplatin requires before and after treatment to prevent kidney damage. Unlike people, dogs do not have a lot of side effects during chemotherapy. They do not typically lose hair, become sick, or have other major symptoms. Nero did not have a single symptom - he came home happy and spritely, and has remained so since. He has figured out how to dig with one front leg, and is back at his hobby of cratering the back yard. He has figured out how to run, and is mastering stairs quite well. We take him for walks regularly again, with which he is overjoyed.

We're just thrilled with Nero's response to his treatment. We will continue his treatment, and will update this page with his results.

June 9, 2000

Unbelievable. I put this page online at 6:30 pm, June 8th, and sent the URL to a few select people, as well as the Deerhound mailing list. In the 24 hours since then, we have had no less than 370 people view this page. I've had many comments, most of which were asking how the incision has healed, and if we had any pictures of him standing. Therefore, I'm including a couple here.

To the right, you will see Nero standing. I took this picture this evening, as he was out on our back deck. He is anxious to go for a walk, and is running up and down the back yard. He's in great spirits, and obviously in no pain!

The other question I had asked of me quite a few times was how his amputation site had healed. I took a picture of it close-up so that people could see it as well. 

It is now exactly three weeks today since Nero's original surgery. He had sutures in for two weeks, and they were removed the day of his first chemotherapy treatment, which was exactly one week ago today. Unless you look specifically for the suture site, you cannot even see that they were there. The incision was in a "Y" shape, with the base of the Y pointing to the left and downwards (think of a "Y" inclined 45 degrees to the right). The surgeon resected muscle at the amputation site, and shaped the remaining muscle to give a smooth, natural appearance at the former site of the shoulder. This is plainly evident here, as the skin is smooth and free of lumps. The only redness is near the base of the "Y" where Nero has been licking the incision site. We had him wearing a T-shirt up until today to keep him from doing this any more, but it's in good enough shape now that he no longer wears it.

The other thing I did last night was to move the NeroCam camera. Nero has taken up residence on the kitchen bed, so I moved the camera and light into that room. If you want to watch Nero sleeping live on camera, visit the NeroCam. If it's night time, you can click a button to turn on the light and watch him sleep. We had over 600 people visit the NeroCam today alone!

June 30, 2000

Nero had his second chemotherapy treatment this past Monday. As with the first, he had absolutely no side effects. No loss of hair, no loss of appetite, no rashes, no sickness, no lethargy. If anything, he was more energized than before, and his appetite was even larger. We couldn't ask for anything more. He's been very anxious to go on long walks since he has returned, and he is constantly asking to go outside so that he can run and jump and play. He has definitely mastered life on three legs. We have a deck in back with four steps that lead up and down to the yard. It originally took him a while to figure out how to get up and down them on three legs. No bother now - he just jumps and clears all four steps at once, just like he used to do on four legs.

His incision has healed, and there is very little scar tissue, a tribute to the surgeons at OVC. The fur is beginning to grow over the incision, and he is showing the "tiger stripe" patterns he had when he was a growing puppy with not a lot of fur.

July 26, 2000

Nero gave us a bit of a scare last week. While at OVC for his chemotherapy treatment on Monday, they discovered a small lump at his incision site. The lump seemed to be somewhat firm, and the worry was, of course, that the cancer had metastasized. They did a needle biopsy of the lump and took some more chest radiographs. The radiographs showed that his lungs remained clear, with no obvious evidence of metastasization. On Tuesday we got the results of the needle biopsy, showing that the lump contained just blood and fluid, and was harmless. Good news!

When Melly first arrived at our house, she decided that she was going to take charge of the dog population, and really beat up on Nero. We felt terrible for him, but we had to let them work it out between themselves. Once Melly realized that Nero was absolutely no threat to her, she relented, and they have since become inseparable best friends - within limits. Before Nero lost his leg to cancer, Melly would NEVER allow him to share the bed, in fact, if he was on it and she wanted to be on it, she would chase him off. However, she now seems to realize that Nero needs a bit more consideration than he used to. You now see them both on it together all the time, and she lets him have the best part (in the middle) while she clings on the edge. Nero has become much more tolerant as well - before, if anyone or anything touched him, especially his legs, while he was laying on a bed, he would get up and move somewhere else. Recently, I've seen Nero laying on a bed with Melly laying across his legs, and Nero was perfectly happy with the arrangement. They've really become a lot closer in the last couple of months.

This afternoon, I brought the video camera out, took the dogs outside, and then asked them if they wanted to go for a walk. This, of course, drives them absolutely nuts, and is one of the few things that will make Nero bark. I did take them for a walk afterwards - they would have made my life miserable if I hadn't!

You can watch the video that I took, which includes Nero and Melly out frolicking on our back deck. If you have a high speed (cable modem, DSL, etc.) Internet connection, click on "high speed", otherwise click on "low speed." The video is one minute and 45 seconds long, in Microsoft ASF format, and requires Windows Media Player to view it.

Nero and Melly Frolicking - High Speed ASF

Nero and Melly Frolicking - Low Speed ASF

September 6, 2000

Just a quick update. We took Nero up to the cottage for the last holiday weekend of the summer. It was nice and cool, and with no shortage of people wanting to take dogs for walks, the dogs were out all the time!

Two nights in a row we took Nero and Melly for a walk down to the beach, on the shores of Lake Huron. The water was warm, and Nero went crazy! He was running and leaping through the water at full speed, chasing Melly around, and generally having just a wonderful time. It's been many months since we saw Nero having such fun, and it was wonderful to see. He was in full puppy mode, running and chasing waves and digging madly in the sand.

Later on, we went to visit friends on the beach who have a one year old Wolfhound, and Nero and he played and rolled around on the sand.

It was simply wonderful to see Nero having such a wonderful time at the cottage, he was in better spirits than we've seen him in for a very long time. We sat and contemplated - had we not gone ahead with the amputation, it's very likely that Nero would no longer be with us now. Watching him romp and play over the weekend, we just knew that we had made the right decision all those months ago.

September 12, 2000

Well, today was the day. Nero's last appointment back at Guelph, for his final checkup. He's finished his chemotherapy, so today's appointment was to check for lung metastases or any other symptoms.

Nero was excited as usual to get to Guelph - they treat him wonderfully, and he really loves everybody that works there. The main difference this time was that there were a lot more people there. OVC is a teaching hospital, part of Guelph University. All summer long there have been very few students whenever we visited. This time, every vet was trailed by a gaggle of young vet students, each wearing a white top and a stethoscope around their necks. Some of them looked a little taken aback at Nero (at his size, perhaps?) but they all got along just great.

Dr. Melanie Brooks, our OVC vet, came in and gave Nero a big hug, then we went off into the back room. I told her about how Nero had been romping in the lake, and that he had been in better spirits than we had seen him in a very long time. She was very pleased!

Nero then went off for his radiographs. Normally they do three different images, each at a different angle. Apparently Nero was not too cooperative this time, so they gave up after doing just two of them.

However, the two they did take were conclusive: Absolutely no visible metastases whatsoever! His lungs are clear. This is great news!

While in the waiting room waiting for Nero to come back out from his radiographs, we met a wonderful two-year-old Golden Retriever. I went through the standard thing I go through with all Lab/Golden owners, about how they may well be the nicest, kindest dogs they've ever known, but that they all growl and get upset when they meet Nero. Of course, they protested and said that their dog had never growled at any dog, and that she loved everyone she met. Sure enough, Nero came out, the Golden took one look, stiffened up, and growled. Her owners gave the same reaction all the Golden owners seem to give: "Wow, she's never done that before! I don't know what's gotten into her!" Never fails, same response, every time. :)

We loaded Nero into the car for the trip home. He was as happy as ever. It's another three months now before he's scheduled to go back for a re-check. We'll watch closely in the meantime to make sure nothing else comes up, and we'll keep updating this page if anything does. Thanks to all the people who have taken the time to write to us - we've received probably two hundred messages as a result of this page.

When we started this all off, virtually all Deerhound people told us that amputation and chemotherapy does not work with Deerhounds. We went that route anyway, and it has obviously worked well. I hope that this page can be of some help to any people going through the same thing with their own dogs, and that it may help you in taking your decision when it is time to do so.

September 16, 2000

A very quick entry: This page is featured as the web site of the week on the Veterinary Information Network's Dog Forum. Thanks, guys!

Also, we found out about a study being done on Deerhounds to try to determine a genetic marker for osteosarcoma. Nero will be participating by giving a blood sample. If you have a Deerhound with osteosarcoma, or if you have a Deerhound, over the age of ten, without osteosarcoma, they would love to have a blood sample from your dog to help further the study. Contact Dr. John Dillberger if you would like to help.

Lastly, we've had a lot of people write to tell us how much help this page has been to them. I thought I'd include one more reference that was of great help to us: It's a book, called "Pets: Living With Cancer" by Robin Downing, DVM. It has lots of useful information and helpful ideas. Highly recommended.

September 20, 2000

It is with a heavy heart that I have to announce the passing of our dear, beloved Nero.

On Saturday the 16th, he developed pneumonia, and was put on antibiotics. With the metastasization of the osteosarcoma in his lungs, he was more susceptible to contracting pneumonia.

He continued to decline, and was put on some more drugs. On Monday he had his last meal, a breakfast of tuna, cheese and Eukanuba. He threw it up shortly afterwards, and could keep nothing down after that.

On Tuesday he refused cheese, for the first time in his life. Tuesday afternoon I noticed his heart rate was greatly increased - up around 140 (where his resting rate was usually closer to 50 or 60) and his temperature was up. I called the vet and he came out again. He gave him a shot of some antibiotics and some narcotic painkiller. By Tuesday evening his heart rate had increased to 160 and his breathing was very shallow. Our vet told me to call him if his heart rate got to 180.

I checked him again at 12:45 am, and his heart rate was at 260, and unstable. I called the vet immediately, and he met us both up at the vet hospital. He did an EKG and decided that we needed to go to Ontario Veterinary College in Guelph immediately. Nero, our vet and I set off for OVC, and we spent the rest of the night there. 

Once at OVC, they did some radiographs. The films showed a large tumor had developed on his lungs - a tumor which did not show up on radiographs taken only one week before. The tumor had ruptured, and had filled his chest with fluid, compressing his stomach, lungs and heart, and causing great irritation both on his lungs and on the inside of his chest cavity. This was causing him a great amount of pain, so more painkillers were administered. The pressure of the fluid is what caused his lungs to be compressed, and to subsequently develop pneumonia.

Our plan was to drain the fluid, but when this was done, it turned out that the fluid was in fact blood, and as it was drained, Nero's blood pressure plummeted, so they stopped quickly.

An ultrasound was then performed which confirmed that the tumor was indeed the source of the blood. We had two options open to us: Surgery to resect the tumor, potentially giving Nero a few more weeks (most of which would be spent recovering from surgery) until the next tumor appeared, or to end it gracefully. Faced with the potential of weeks of continual pain and constant medication for him, and knowing that he was now suffering greatly, we decided after considerable consultation to take the painful (for us) second option, and let Nero slip from this world into the next, where he will be waiting for us.

He will be sorely missed by us all, and, I suspect, by a great many other people who have never met him.

We've been preparing for this day for months now, but it certainly doesn't make it any easier.

Thanks to the (literally) hundreds of people who have written to us and to Nero. We will never forget him, and we hope you won't either.

"For Nero"

He left home early in the fall, 
His disappearance felt by all 
Of us. 
The words that come after 
Sound awkwardly sentimental 
Only because they're not enough. 
There aren't words that could call us back 
To the home lost by his absence. 
There aren't words to fill the space left 
By the departure of the love 
Of a dog held by human hands 
Unable to do anything 
But let him go.

Chris Waldrop

Stranwith De Niro
February 21, 1994 - September 20, 2000

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