What this means is that we can now rule out bacterial infection and fungal infection from the list of things that could be causing First's problem. There is now really only one thing left on the list. Well, there are two but the vet has ruled out the likelihood for it to be a foreign body because of the slow way it started and the lack of infection. That leaves tumours.
I have been thinking about this quite a lot, and doing research. Here are some facts:
1. Tumours that grow in dogs' noses come in three categories, one of which is likely to metastasise.
2. There are no signs of any metastasis in First's chest x-rays.
3. All of these tumours are malignant. None are curable.
4. Treatment of these tumours is the same as for a person - radiotherapy, chemotherapy, surgery.
5. Surgery alone does not extend the dog's life expectancy all that much.
6. Life expectancy for these kind of tumours varies from 3 months to 2 years depending on treatment.
So those are the facts. Other pertinent facts:
1. My dog is 12 years old.
2. She's not currently showing any signs of distress.
3. She is showing symptoms - stuff is still coming out of her nose (although not currently fresh blood) and she still sounds like she's breathing through a pipe. She's also started harrumphing occasionally as if she has phlegm. I think this is intake of breath through the mouth causing her lip-bobbles to flap around:
Photo of dog lip-bobbles for those who don't hang out with dogs much:
Those things make a harrumphing noise when she breathes in sometimes. So I'm guessing the blockage in her nose is sufficient that occasionally she has to breathe through her mouth to get enough air, but other than that she's shiny-coated, not losing weight, not obviously in pain*, eating, drinking and bouncing around like a dog half her age.
* This is a hard one. This dog worked sheep for an hour after having ripped all four paw-pads off and didn't limp once - I only knew because I saw the blood. Others of her breed have given birth to litters of puppies while working sheep, or dropped dead while working sheep. They don't show pain and sickness in the same way that other breeds might. But I know my dog and I'm pretty sure she's not suffering pain at the moment.
OK, so those are the facts. The final pertinent fact is that it will cost $1400 for an endoscopy and CT scan at Massey which would confirm or rule out the existence of a tumour.
This is where it gets hard. $1400 is a lot of money to spend to confirm your dog has a terminal disease.
You see the thing is, I lost my last dog at 12 with cancer. With her, I waited until she was having more bad days than good days before ending it. In retrospect, I should have not waited that long. It was unnecessary suffering. Last year, I lost my Mum with cancer. Because she was a person, she had to wait until the disease killed her and tolerate all the suffering that went with it. Given the choice, I would have opted to end it before she lost her identity, her joy and her ability to be self-actualised. With First, I have that choice.
I have decided that should it become clear First has cancer, I will have her put down immediately. She is 12 and has had a long and happy life, she's healthy (apart from the obvious) and she's happy. She has energy and lives without pain. That's how I want the end of her life to be, not the way it was for Mum and for Bottles. This is my decision.
So, the question then becomes, why spend $1400 if this is the expected outcome? Who knows, it may reveal something else, something easily fixed, that will let my dog live comfortably.. but for how long? She's 12. Most heading dogs die at 12-14 anyway, so would I simply be buying her a couple more years for the sake of my own emotional comfort?
This is one of the things that's been on my mind the last few days. I will wait till the third test comes back, and hear what the vet has to say. Maybe there's something she forgot to tell me, that I haven't found in my research. If that's the case I will revise my decision based on the new information. But the reality now is that I'm pretty sure I'm about to lose First. I'm ok with that, rationally. I know I'm doing the right thing. Emotionally? I'll get there.
Life without a dog will be very strange.
So there you have it. I'm not the first person ever to be faced with this decision and I won't be the last. In the grand scheme of things it's not a big deal. But in my world, the one where First is a common thread through my adult life, it's foundation-rocking.