The Everyday Cafe

13-year-old Sally was diagnosed with intestinal lymphoma today. It’s usually a treatable kind of cancer — at least treatable insofar as you can use chemotherapy to put it into remission for months or even a year. We will find out more about her prognosis and our options at the visit with the veterinary oncologist on Friday.

Is it outrageous to treat a dog with chemotherapy? Here are a few things I’ve learned:

• Most dogs don’t suffer horrible side effects from chemotherapy. We approach treating cancer differently in dogs compared to in humans — less with the goal of complete cure and more with the goal of achieving some additional months of good quality life.
• Chemotherapy can be expensive of course. We will consider the probability of remission, the cost of various protocols, and the chance that Sally will feel more miserable than not if we treat rather than giving her only palliative care, among other things.
• The decision to treat a dog or not and how seems in some ways more rational than how we make our human health care decisions. There’s rarely insurance involved so the owners bear the cost of treatment. Euthanasia is an option. Palliative care may be chosen even when more aggressive treatment might put the cancer into remission. Of course when a human life is at stake, we have a different set of values and priorities than when a dog’s life is. But it is an interesting comparison to think about, for how it might inform human health care decisions.

I always thought Sally would get to be a doddering old doggie before she died, that she’d reach the point where we’d say “it’s time for her to go.” But she’s not at that point yet, even though she’s 13. A neighbor recently commented, “she’s 13 going on 3″ because of Sally’s exuberant playfulness and puppy-like demeanor.

Now it seems we’re all too close to a goodbye.

*Painting of Sally by Susan Reed. A gift from my father.