DIAGNOSIS
Dr. O'Neal said she'd be blunt. She explained that Xaros had a mass on his spleen, and it was most likely Hemangiosarcoma. This is a particularly nasty cancer, it spreads rapidly. She said if the lungs are clear on x-ray, removal of the spleen was the treatment. With a splenectomy, if the cancer hadn't grossly spread, he might get, on average, 2 more months.
I was devastated. I couldn't believe that Xaros, who seemed so happy and healthy just a few days ago, could have a fatal, malignant cancer! His eyes still were sharp, he was looking around wondering what was going on! This couldn't happen to Xaros!!
I guess one of the problems of being an adult is that reality sets in. As a child, you can choose to believe what you want. As an adult, you discover that sooner or later, you must face the truth.
The cancer itself grows within and on blood vessels. Anywhere there is a blood vessel, tumor can form. The tumor or the vessel wall can rupture, causing bleeding. If it is only a small amount of blood, no signs or symptoms are noted; the bleeding stops, the blood is reabsorbed. Just like a little cut.
A little larger bleed causes some signs and symptoms. Loss of appetite and lethargy are common. That's what made me take Xaros to the vet in the first place. If the bleeding stops, the blood is reabsorbed, and everything is OK. If the bleeding doesn't stop, the dog becomes weaker and weaker, slipping into shock and then death.
A massive bleed, of course, causes sudden death. The bleeding can occur anywhere: bleeding in the lungs fills them with fluid and causes a subsequent "drowning" of the patient. Bleeding into the brain can cause seizures and death; bleeding around the heart results in shock and death.
Dr. O'Neal explained that even with a splenectomy, if the tumor was the sarcoma type, Xaros's future was bleak. If the tumor was benign, removal (and possibly chemotherapy) was a cure. Unfortunately, almost all of these type tumors are malignant.
Removal of the spleen takes the current bleeding away. If there are no other tumors, chemotherapy can be attempted; some dogs have lived up to 18 months or more, though the average was around 6 months with chemotherapy. Problem is, the tumor is always there, just on a microscopic level. It can grow rapidly and create havoc anytime. Chemo just slows it down.
The surgery itself is not without peril. Among others things, Xaros could bleed to death on the table if the mass ruptures; he could develop cardiac arrhythmias (irregular beats of the heart); he could have a reaction to the anesthesia.
I had to make a choice. I looked into Xaros's eyes. They were sharp and alert. When I saw the life still in his eyes, I knew I couldn't let him go. Not yet. He still wanted to live. Dr. O'Neal said that the quality of life after surgery is usually excellent.
Off to surgery it was.
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