Reggie, my ball-crazy golden retriever, had a lump removed from his lip in late November. It turned out to be malignant oral melanoma. Even with surgery, some dogs live only six months.
He is 13, an old man with a weak back. His face is white. But don't give up on him just yet.
Four times since December, one of his thighs has been inoculated with a DNA vaccine designed to trick his body into attacking any remaining melanoma cells. His immune system must make a new enemy of an old friend: the enzyme tyrosinase, which gives his nose its black pigment but is also a marker for melanoma. The vaccine contains the DNA coding for human tyrosinase, just different enough from the dog version to provoke an immune reaction.
If it sounds expensive, it is: $2,200 for the first four vaccines, with a booster every six months.
I'm probably like a lot of people: amazed at the science and unnerved by the choices that I make for my loyal friends.
Growing up, we never consulted veterinarians. Sick animals died. In the past four years, Reggie, Dixie and the late Abby have seen not only skilled vets but skilled specialists: a veterinary surgeon, neurosurgeon, dentist, internist, oncologist, cardiologist, ophthalmologist and assorted ER doctors.
All three golden retrievers have been surgically treated for early-stage cancers.
I am, of course, always broke. I drive a 9-year-old car, clip coupons and save rewards points. I turn to my sister, a doting dog aunt, in a pinch.
I wonder: Where will I draw the line? The answer is complicated and unique for everyone.
Veterinarians see owners stop treatment long before medical options run out. Some can't pay; others think it's foolish. People worry about putting a pet through surgery. Or they apply a human definition of dignity. It's hard, no matter.
"Only the pet's owner can know how far to go versus not," says veterinary oncologist Philip Bergman of New Bedford, N.Y., primary investigator for the Oncept melanoma vaccine.
"They know their pet better than anyone else in the world, and they also know their own personal situation — fears, history with cancer, financial state, etc. — better than anyone else."
When deciding for our pets, we draw on emotions that fuel many human decisions: fear, shame, guilt, respect, pride and courage.
It takes courage to euthanize a dog, and sometimes it takes courage to keep one alive.
I learned that lesson from two experiences with canine vestibular disease, which brings symptoms of vertigo, head tilt and rapid eye movement. It can mean a brain tumor or inner ear infection. But it can also be idiopathic and temporary. You wait, not knowing if your pet is dying or just dizzy.
Summer before last, well into her 15th year, Abby showed those symptoms, along with rigid limbs and lethargy. After observation, the emergency vet at a state-of-the-art center felt certain it was a brain tumor. I signed paperwork, slipped my hand beneath Abby's face and, through a stethoscope, heard her last heartbeats.
For a long time, I regretted her overnight stay in the noisy infirmary, hooked up to machines. Why had we made her wait?
The answer came 17 months later: hope.
It was Dec. 29, the Saturday before Reggie's second scheduled melanoma vaccine. I was cleaning up after supper when he staggered and fell. I put him to bed and watched, with disbelief, the twitching movement in his eyes.
By morning, his head was tilting 45 degrees to the left. He couldn't lap water from a bowl. I squirted it into his mouth with a syringe.
I called his longtime vet, Jean Mahlman, by now a good friend. We had the same thought: melanoma, metastasizing to the brain. In dogs, 80 percent of oral melanomas metastasize. The next day, Reggie had to be carried on a cart to see his internist, Gary Oswald. The vaccine got put on hold.
If it was a brain tumor, it would get worse.
For most of a week, he just slept — at home, with me. A few times a day, I carried him with a body harness through the kitchen, down a step to the deck, down two steps to the grass. But vertigo kept knocking him over.
On a nice January day, I left him sitting in the grass while I went for the phone indoors. I returned to find him smiling in the doorway. He had scaled the steps alone. He wasn't giving up.
Next he mastered the water bowl. He learned to right himself. He slowly bent down and touched a ball with his nose.
I know these are borrowed days. I know I can't stop time. But I can fight alongside him, and make sure he doesn't suffer.
This vaccine, intended for postsurgical use, has a difficult time overcoming established lesions. But most dogs survive at least two years instead of six months.
Reggie's lymph nodes, so far, are good. His chest X-ray showed only an old, stable nodule.
Dare I hope? On Monday, I drove Reggie to see his neurosurgeon, Anne Chauvet. She fixed the bad disk in his lower back, coddling the incision with hyperbaric oxygen and laser therapy. I could have taken two cruises for what I spent, but it wouldn't have had the same effect.
She has an MRI machine.
The MRI showed the worn spine that one might expect of an old, ball-chasing dog.
And a brain. It showed a normal brain.
Times staff writer Patty Ryan can be reached at [email protected] or (813) 226-3382.