November 2023

Paying for cancer treatment

November 28, 2023November 29, 2023 by Pawrenting Tails, posted in finances, resources

Last week, in anticipation of Thanksgiving, I wrote about what I’m grateful for in our canine cancer journey. Following the shopping “holidays” of Black Friday and Cyber Monday, what better than a post about affording cancer treatment?

What will it cost?

No one can accurately estimate what treatment will cost because it’s determined by many factors. First is the kind of treatment you’re choosing. Surgery, chemotherapy, supplements, radiation, or some combination of those will all affect the costs.

Second is where you live and your options. Like everything, where you live influences the cost of services. Similarly, suppose you want to pursue treatments that your veterinarian doesn’t offer (e.g., chemotherapy or radiation), and specialists are hard to come by in your area. In that case, you may choose to travel for treatment. That will add in another layer of costs – travel expenses.

Third is for how long you are treating your fur baby. Ziggy lived 17 months post-diagnosis. He had surgery, six rounds of traditional chemo, and then went on a low-dose at-home chemo pill. Our oncologist advised that the standard protocol for the at-home chemo is six months. It was safe to continue on it long-term, so we kept him on it until the end. When a mass was found on his spleen, we were going to attempt traditional chemo once again (a different protocol), but Ziggy’s health took a turn before we could continue.

Meanwhile, Cookie had a total of three surgeries in two years and is on the low-dose at-home chemo. She has been on it for nearly seven months and counting.

Not counting supplements, we have spent about half of what we spent (out of pocket) on Ziggy on Cookie so far.

More details about what affects the cost of treating cancer can be found in this DogCancer.com article or this DogCancer.com podcast episode.

Insurance

One reason we can choose ongoing treatment for our pups is through pet insurance. Each time we bring home a pup, the first thing we do is to sign them up for pet insurance. I plan to dedicate a post to insurance, but my key bits of advice:

Get it early, before health issues arise. Pre-existing conditions are real!
Choose the highest maximum annual coverage. Increasing it later on will constitute a new plan and any health issues previously found may be considered a pre-existing condition – even cancer.

Financing

Almost everything that we pay for out of pocket we use Care Credit. Yes, it’s a credit card, but it offers no interest financing for at least six months for purchases over $200.

Like any other purchase, you should spend within your means. The benefit of the financing options allows you to spread the cost over time instead of taking a huge hit all at once.

The veterinarians you visit must accept Care Credit as a payment option. Every practice we have been to (at least four in the last three years) accepts Care Credit. What varies by practice is the number of months of financing that they offer. Some only offer six months, while others offer up to 24 months.

Some practices with multiple options would give us the choice of how many months to finance, while others would choose for us based on the amount of our invoice.

Since applying for Care Credit, we were “upgraded” to a MasterCard option, allowing us to earn points on purchases at Care Credit practitioners and other retailers. You can redeem the points for gift cards or statement credits. We apply the points as statement credits to lower the cost of the vet bills that we pay out of pocket.

Read this DogCancer.com article about Care Credit, or visit their website for more information.

Other options

There are other options for paying for treatment that I don’t have first-hand experience with but have read about.

One option is clinical trials. You’ll most likely need to live within travel distance of a veterinary college. There are pros and cons to participating in a clinical trial. While you may get free treatment, there’s a risk that instead of treatment your dog gets a placebo. That may be a worthwhile risk if that’s your only option for affording care. It’s important to note that costs of care may not be covered by the trial, so it’s worth doing your homework before enrolling.

Another option is to look into organizations that may offer grants or other types of financial aid to cover the costs of cancer care. This DogCancer.com article overviews some of the organizations that provide financial aid.

For additional advice, listen to this DogCancer.com podcast episode, where one dog racked up $60,000 in vet bills, or this episode highlighting creative solutions and difficult conversations.

Final tips

My top recommendations from personal experience are to sign up for pet insurance and research whether Care Credit is right for you.

When discussing treatment options with your veterinarian, discuss the cost and your financial situation. They can provide estimates for the treatment so you can research payment options and consider them when choosing what treatment is right for your pup.

Discussing your financial situation with your veterinarian may enable them to offer alternative diagnostics or treatments or even share discounts that their practice offers (e.g., a multi-pet discount).

Bottom line: Don’t assume that care is out of financial reach without getting written estimates from your vet and researching options to help offset the costs.

What I’m thankful for

November 22, 2023 by Pawrenting Tails, posted in General/About Me, health

It’s the season of gratitude, and while we’re in a stable spot on our canine cancer journey, I’m reflecting on what I’m thankful for in how we experienced canine cancer.

The Pandemic

The pandemic was a source of fear, stress, and anxiety for all of us. But without it, I wouldn’t have been working from home and able to catch Ziggy’s limp. It’s impossible to know whether we would have caught the cancer as early as we did without the pandemic, but catching Ziggy’s cancer early was certainly a critical factor in his survival time.

The first dog

Ziggy the happy patient after his last traditional chemo treatment, April 2021. — Ziggy, the happy patient, after his last traditional chemo treatment in April 2021.

I absolutely HATE that Ziggy was diagnosed with cancer and amputated a leg before his second birthday. It kills me that he died shortly after his third birthday. But I am grateful that he was the one to lead us on the cancer journey.

Ziggy was the best patient. He always smiled when going to the vet (which was a near-constant occurrence once he was diagnosed). He easily adapted to the tripawd life and showed us what resilience is. Ziggy’s pawsitive attitude and resilience made it easier for us to make treatment decisions and to figure out ways to maximize his quality of life.

Seeing how well he responded (physically and emotionally) to these challenges gives us the strength to make the best decisions for every other dog.

The unexpected prognosis

When we at long last learned that Ziggy’s cancer was hemangiosarcoma, we were devastated and afraid because of how short that prognosis tends to be. He was already three months post-diagnosis when we confirmed the type of cancer. We were incredibly fortunate to have 17 months with him post-diagnosis.

It would never be enough time, even if he’d lived to age 10. This success with cancer treatment not only softened the devastation of losing a pup so young but also gave us an optimistic lens when confronting the cancer journeys of subsequent pups.

Cookie’s Simpler Journey

Cookie recovering from surgery April 2023. — Cookie recovering from surgery in April 2023.

When I first found Cookie’s lump on her leg in July 2021, my heart sank. How could we handle a second dog with cancer? Why is this happening so close to Ziggy? Given their age difference, it should have been unlikely.

While the prospect of two dogs with cancer simultaneously sucked, I’m grateful that Cookie’s cancer (soft tissue sarcoma) was less serious and more easily treated. She’s a terrible patient and tries to find a new family after each surgery, which are two reasons why I’m relieved that she hasn’t needed traditional chemo or radiation.

Veterinary Staff

We’re fortunate to have an amazing holistic veterinarian, his patient and compassionate staff, a terrific veterinary oncologist, and the oncology care team to help keep our pups healthy.

Lessons Learned

I would never wish this on anyone, but this journey has taught me a lot. Sometimes, it seems like common sense (e.g., fresh food is better than processed kibble); everything I’ve learned helps to improve the care for Cookie, Chip, and any other dog that comes along. There’s plenty more that I could (or want to) be doing, but I do the best that I can right now. And I look for opportunities to make improvements wherever and whenever I can.

All the sources that have taught me about healthcare have exposed me to other resources, such as trainers. Exposure to more perspectives in all areas helps me be a better dog pawrent. It’s helpful when encountering new challenges, such as an anxious and sometimes reactive Chip.

Every day Gratitude

Most importantly, these cancer journeys are reminders to say yes to the pups as much as possible. To take them out for activities that bring them joy (like Cookie’s recent beach day and slide escapades). To let Chip lay on me a little longer in the mornings before getting ready for work. And appreciate all the time we are given because you never know when it will end.

Cookie’s Cancer Journey

November 15, 2023November 14, 2023 by Pawrenting Tails, posted in health

Cookie’s cancer journey is less dramatic than Ziggy’s, but it’s scary in its own right.

How it began

In July 2021, nine months after Ziggy’s diagnosis, I spotted a decent-sized lump on Cookie’s front left leg, right by her elbow. It shocked me because of its size – that of a very large grape. I was surprised that I hadn’t noticed it sooner. We monitored it for a few weeks before scheduling an appointment with our vet in early August.

Though the vet felt confident that it was benign, I know from Dr. Sue Cancer Vet, that no one could tell whether a lump is benign or cancerous. So we aspirated. It was inconclusive.

Unsure about aspirating again to get another inconclusive result, we scheduled a consult with Ziggy’s oncologist. He was concerned that it may be a soft tissue sarcoma. He recommended surgery to remove and biopsy the lump.

Our primary vet did the surgery and opted for conservative margins. Given the location, he was worried about healing if the margins were too aggressive and it turned out to be benign.

Cookie's front left leg showing the suture site after her initial surgery. — Cookie’s suture site after the initial surgery.

Sure enough, the biopsy confirmed a low-grade soft tissue sarcoma. It required a revision surgery to get full margins.

Cookie’s surgeries were outpatient surgeries with an easy recovery. But each time I picked her up, she tried to leave with another family! And she gave me the cold shoulder for 24 hours. She’s a pretty different patient compared to Ziggy.

Cookie sitting on a bench at the vet, ready to leave before having her revision surgery. — Cookie was ready to leave before her revision surgery.

Cookie didn’t require further treatment, but we did chest X-rays every few months as a precaution. She was probably already on the same diet as Ziggy, but we added some supplements to improve her care.

Oops, it happened Again

In March 2023, a year after Ziggy passed, I saw the same lump in what seemed to be the exact same spot. We again did an aspirate, which indicated the lump was likely cancerous.

This time, our vet recommended a consult with a board-certified veterinary surgeon. He was concerned about the difficulty of the surgery, given it would be round three in nearly the same spot.

The surgeon wanted us to consult with the oncologist before proceeding with the surgery. In her written report, she was concerned about the ability to get full margins and indicated that amputation may be the best approach for a curative result.

The possibility of a front leg amputation on our first furbaby, an agility athlete, gutted us. My husband was immediately against the possibility. I also wanted to be, but I wanted to hear what the oncologist had to say – what the different prognoses may be with different treatment options.

Fortunately, the word amputation never came up with the oncologist. He said the lump was technically not in the same spot, so it wasn’t a recurrence, and removal would be curative.

Cookie post-op after the second lump was removed. You can see the size of the suture site compared to the first.

Cookie wore a surgery suit and a leg sleeve since she had bumps removed on both sides. I highly recommend these suits - far more comfortable than a cone! — Cookie post-op after the second lump was removed. You can see the size of the suture site compared to the first.

We did the surgery, got clear margins, and also removed a giant lipoma from her other side. Cookie did well, but this was a slightly harder recovery for her as she’s a little older, had surgery on both sides of her body, and had a younger brother to contend with during her recovery.

One product I highly recommend is a surgical suit or recovery sleeve (I’m an Amazon affiliate and can earn on qualifying purchases). Since Cookie had the lump and lipoma removed on either side of her body, she wore both to protect the suture sites and remained cone-free until the sutures were removed. It’s wise to get more than one to swap them out while washing one.

Ongoing treatment

Cookie, fully recovered, is judgmental about the fake corn maze in Florida.

Our oncologist gave us the option of putting Cookie on chlorambucil, a low-dose at-home chemo treatment, to reduce the likelihood of recurrence for ongoing treatment. Typically, pawrents opt for six months of treatment as it is the standard of care and for financial reasons. We’re fortunate to be able to afford to continue her on the chlorambucil. It’s a chemo that is safe for her to take longer, especially since she’s tolerated it well. We check in with the oncologist every two months and will do chest X-rays every six months or so.

F*ck. My dog has cancer

November 8, 2023 by Pawrenting Tails, posted in General/About Me, resources

I’m so sorry to hear that. Cancer sucks. Here’s my advice on what to do based on my experience.

Feel your emotions

Whether your furbaby is old or young, showing symptoms or not, the cancer diagnosis is likely to feel like a punch to the gut. There’s no right or wrong set of emotions to feel. You may be sad, angry, anxious, or afraid. Allow yourself the grace to feel your emotions.

Don’t try to suppress your emotions. It will only blow up later. Do try to process them away from your furbaby if possible. I know it may be hard, but they pick up on our emotions, and you want to minimize them picking up on the anger, sadness, or fear, which can increase their stress.

When dealing with Ziggy and Cookie’s diagnoses, Ziggy’s especially, we bawled, cursed, and screamed. We did our best to have the worst of our breakdowns away from the pups to minimize their stress. It’s not always easy or possible, but do what you can.

Take action

Photo by Tima Miroshnichenko on Pexels.com

Once you’ve taken a beat to digest the news and process your emotions, it’s time to take action. That can look like many different things, depending on many factors.

You may want to consider a second opinion, which may come in the form of a specialist (i.e., a veterinary oncologist) or simply another vet. We did both with Ziggy because of his young age and our hope for a less traumatic diagnosis. Additionally, it was a few weeks before the oncologist could see us, so a second opinion with another vet was a good checkpoint while we waited for the oncology consultation.

I highly recommend a consultation with a veterinary oncologist. They’re more likely to be able to give you a range of treatment options, give you information on a prognosis, and other important details. If there isn’t a veterinary oncologist near you, you may be able to do a virtual consult (thanks, pandemic!) or at least have your primary vet consult with one.

On the American College of Veterinary Internal Medicine’s website, you can search for a specialist using their “find a specialist” search tool.

Learn More

Being human isn’t easy these days, and you may not have the privilege of time to do so, but I strongly encourage you to do what you can to learn more. Beyond the conventional treatments (surgery and chemo), most of the additional treatments that we started for Ziggy and Cookie (e.g., supplements, home-cooked foods, etc.) are ones found through DogCancer.com‘s resources.

The Dog Cancer Survival Guide (I’m an Amazon affiliate and may earn based on qualifying purchases) is my top recommendation. They present many treatment options that vary in cost and time intensiveness. They also have short podcast episodes, though I recommend selectively listening to topics of most interest to you based on your dog’s journey. Their Facebook support group can also be a source of comfort from fellow pawrents who you may relate to better than your family and friends.

Be your pup’s advocate

No one knows your pup better than you. If something doesn’t feel right, don’t do it. Consult with experts and others who have been through something similar, but remember the key difference: you and your dog.

You know your situation best. I do encourage you to explore and consider various options. That may include aggressive conventional treatment, hospice care, holistic treatments, or a little bit of each at different points in your journey. Everything from your pet’s age, cancer type/stage, and personal circumstances (i.e., financial ability, time constraints, etc.) will influence your decisions.

Treatment can add up financially, but there may be options to help with the costs. I plan to write about the tools we use to help manage expenses, but there are more options out there that I urge you to explore.

Dogs don’t have expiration dates

Don’t let anyone tell you that your pup only has a certain amount of time left. I’ve heard this repeated countless times with the DogCancer.com community – dogs don’t have expiration dates. Your vet or oncologist may tell you that with or without treatment, your dog has an average of N days/weeks/months. But that is an average that doesn’t include your dog.

Hemangiosarcoma is one of the most aggressive canine cancers. When Ziggy was diagnosed, we feared he may only have a few months. He lived 17 months post-diagnosis.

My parents’ dog, Brie, went to the emergency vet one night after collapsing (due to internal bleeding). She wasn’t supposed to survive the night, but my parents took her home when she returned to her usual self. Brie lived five months after that. While never officially diagnosed with cancer, based on what I learned about hemangiosarcoma, I suspect that’s what she had. With no treatment, she lived five more months being spoiled with all kinds of yummy food and love. The emergency vet suggested they could do surgery, but there was a possibility that she wouldn’t survive. My parents opted to take her home and forego treatment.

Ziggy coming home after his splenectomy.

What is right for one pup and one family may not be right for another. Even within one family, you may make different decisions for different dogs. Ziggy was young, and he was an EXCELLENT patient, going to the vet with a smile on his face. Cookie and Chip aren’t as easygoing as patients. That may factor into what options we choose for them.

Ask for help

Being human is hard. Being human while caring for a sick pet is harder. Whatever path you choose, ask for help. It may not be caring for the sick furbaby, but it may be helping with other stuff so that you can care for your furbaby.

Cherish every day

Ziggy enjoying a stroll in Key West 7 months after his amputation.

Most important: cherish each moment with your furbaby. We should do this every day, even when they’re healthy, and with all of our loved ones. But being human is hard, and sometimes we get caught up in the little things that don’t matter.

When they’re sick, regardless of what treatment path you choose, prioritize their quality of life. Do what you can to do more of what makes them happy. You won’t regret it.

	Pawrenting Tails on Stepping Back
	José Alvarado on Stepping Back
	rezhall on What we’ve been up …
	rezhall on The Fifth Ziggyversary
	rezhall on It’s been two years