You can’t help it: Reconsidering past decisions after a devastating diagnosis

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It’s been nearly 2 1/2 years since we lost our precious dog Linus to hemangiosarcoma. He was a sweet, silly, athletic Portuguese Water Dog and was just shy of his 10th birthday. 

We got up one Saturday morning in April with plans to play at the park, then give him a bath in preparation for his first therapy dog visit the next day. My husband, Paul, got up before me and I heard him say, “Hey buddy, are you okay?” Linus was laying down panting in the hallway. When we went out to the family room, Linus ambled out and dropped to the ground. We called the emergency vet to let them know we were on our way. 

I had to carry Linus to the car and into the veterinary hospital because he couldn’t stay on his feet. They took him back right away. After what seemed like an eternity, the veterinarian came out and said that Linus was in severe shock and appeared to be bleeding into his belly. I have a number of friends who have lost dogs to HSA, and I was terrified. I kept asking, “Do you think it’s hemangiosarcoma?” I remember thinking it was so surreal to be sitting in the vet office hoping that my dog had ingested poison, because at least there may be something to do about it. 

They did an ultrasound, which found multiple masses on Linus’ spleen and liver.

The veterinarian reviewed our options: surgery to remove whatever tumors he could (but it was likely that Linus wouldn’t survive surgery); try to slow/stop the bleeding and buy some time (likely a few days); or make no attempt at treatment and let him go. I just couldn’t believe that a few hours before we were making plans for the weekend and now were contemplating how to manage Linus’ final hours or, at most, days. I desperately wanted to get him home; I didn’t want him to die in a vet office. We decided to try to control the bleeding to see if he could improve enough to make it home. The vet called a couple hours later to say that despite transfusions and medication, Linus’ clotting function was non-existent and we needed to make a decision. We raced back.

We found Linus in so much pain and distress that we decided we needed to help him depart immediately. Another situation I never imagined – please, please hurry and euthanize my wonderful dog. Linus was gone in just a few minutes. My beautiful, funny, intelligent, loving dog who always lived life to the fullest was gone.

Second-guessing, so hard

I can’t count the number of times I’ve pondered the decisions we made over the course of Linus’ life. Did this or that contribute to his cancer? 

Linus had allergies that began before he was a year old. We tried everything under the sun: elimination diets, frequent baths, various medications, etc. He was on Apoquel for some time; it helped significantly with his itching. Sometime later he developed a nasty skin infection, which we treated with antibiotics and increased the Apoquel. A few months after that, I found some small black growths on the skin of his elbow. We had them biopsied, and while they weren’t harmful, the dermatologist said Linus’ immune system should have prevented them from growing; the Apoquel may have suppressed his immune system too much. We discontinued the drug; fortunately, what is now Cytopoint was newly available and we started that with success. Should we not have used the Apoquel? I have no idea. I do know that it gave him relief when nothing else seemed to help and made a drastic difference in the quality of his life.

Another event happened about 10 months before he died. He had ambled across a yellowjacket nest in the ground and a number of yellowjackets stung him. I’ve never seen anything like it. It was awful. His face puffed up like that of a prize fighter. The emergency vet treated him with antihistamines and a two-week course of steroids. Another immune suppressor – might that have opened the door to the cancer? The timing makes me think it’s possible. I’m not a fan of steroids, but for his situation, I think it was necessary to help him recover.

A month or two later he seemed not quite himself – a bit less enthusiastic about things he usually loved. Then he recovered. He had his annual physical a week or two later. Everything seemed fine. I told the vet that he had this period of a few weeks where he was a little subdued. I said, “You know I’m scared to death of hemangiosarcoma.” He said we could do an ultrasound if I wanted, but added that there wasn’t much that could be done for HSA. In the unlikely event that we had been able to detect HSA at that point, a splenectomy and chemo might have bought us just a couple more months. His last six months of life were great, and it would have been heartbreaking for us to have spent that time dealing with the discomfort of treatment that would likely accomplish little.

On the other hand, I was comforted by the fact that for most of his life we gave Linus a raw, fresh diet. I loved making his food, and he loved eating it! I hope it helped him live longer than if he had been on a different diet. 

The multitude of questions continue to swirl in my head and heart. In the end I try to remind myself that we made the best decisions we could at the time with the information we had, always with the intention of providing Linus the best life possible. And most importantly, we loved that wonderful dog and enjoyed a beautiful life with him. – Joanne Osburn

Related Posts

Hemangiosarcoma in Dogs
You can’t help it: Reconsidering past decisions after a devastating diagnosis
On the Horizon: Hemangiosarcoma Studies

15 COMMENTS

  1. Was Linus neutered? Studies of cardiac tumours in dogs showed that there was a 5 times greater risk of hemangiosarcoma – cancer of blood vessel lining – in spayed females than intact females and a 2.4 times greater risk of hemangiosarcoma in neutered dogs as compared to intact males.

    • Good points, although there are so many pros and cons to sterilization. Luckily there are some alternative procedures that can leave hormones in tact. With a female dog though, there are risks associated with leaving those hormones in tact that I feel can outweigh risks of taking them away. It’s so hard to know.

  2. We lost a beloved dog in 2017 to Hemangiosarcoma. When I look back, there were some warning signs but nothing you could say “ahaa!” . We had gone kayaking the day before and she had hiked within the past week of that fatal day. My only consolation was we were there for her when she collapsed. She was 12½ years old and healthy until the end. I always ask myself what could I have done to my her life longer.. could I have altered this path? Not a day goes by where I don’t think of her at some point. She was “that dog”.

  3. Having had multiple dogs who have gone for a variety of reasons: cancer, old age, etc, I think when we really care about our pets, we will always say “what if”. I do it for dogs I lost back 15 years ago. I try to tell myself that we did the best we could with what we knew at the time. My husband tries to make me feel better and tell me “just think of the knowledge we know have to help future dogs” but that does not seem to help. As long as we are there for them at the end, I feel okay.

  4. Reading your (HSA) story of Linus brought tears to my heart. I, too, lost my beloved Portuguese to Hemangiosarcoma. Deke was 14 and extraordinarily healthy his whole life. He went for a two mile walk in the snow the day before he collapsed. It was so frightening and shocking…we raced him to his vet who, after confirming HSA, took him in for emergency surgery. We were ‘happy’ when we learned the tumor was on his spleen…offering us a glimmer of hope. We took Deke home and he immediately became his own Portie self…full of fun and energy. We were so happy with his outcome, until two weeks later when he suddenly collapsed again. Tests show his heart was filling with fluid…and he was struggling to breath. We made the heartbreaking decision to give him peace and comfort. He died in my arms…and took my heart with him. It all happened so fast that we had little time to think. In a matter of two weeks we went from (what we thought) a healthy, energetic dog…to an end of life decision. I refuse to question myself as to if we made the ‘right’ decision. In my heart I know I did everything I could…and I know any other decision would have been only for me and my desire to have more time. Deke gave me so much fun and happiness, I couldn’t force him to struggle with life. I comfort myself knowing he did not suffer, and my vet assured me he was not in any pain. Death with dignity…
    I now have a ‘new’ Portie…and I know HSA will lurk in my mind… The Portuguese Water Dog Foundation is working on this horrible disease….hopefully breakthroughs will come soon.

  5. Thank you for relating your story about Linus. Nothing can prepare for the sudden onset of HSA. My first golden, Willie, had a skin growth on his chest that grew at an alarming rate. I had it removed, but the vet couldn’t get the tenticles. He lived almost a year to the date of his surgery, and then he told me it was time. With Willie, I had time to research HSA and understand what I was going to do with consultation with his wonderful vet. At age 14 I euthanized him and he died in my arms. two weeks later his blood nephew age 8, who was a voracious eater, turned up his nose to a treat. I had a foster litter at the time, and the caretaker called me to say that he was “off.” Wouldn’t take the treat. I knew something was wrong. I raced home and took him to the vet. He was bleeding internally, and we decided on surgery. When two doctors opened him up it was devastating. When they told me, we made the decision to not allow him to wake up. I had no time to prepare for this tragedy. My two beautiful golden boys were gone within two weeks of each other. HSA is very tragic because of the suddenness of symptoms and the inability to treat it.

  6. Descriptions of difficult times reminds me of my previous fur babies. My present dog is 1 year old and hopefully years away from any problems, but whatever happens it has been worth the time, effort & heartbreak. The saying comes to mind,”It is better to have loved and lost than never to have loved at all.” Also, there are always so many dogs who need homes, that opportunities to love again abound!

  7. Sigh. I read this article online just a couple of days after I suddenly, tragically lost my girl ‘Scout’, a PWD, in less than 24 hours of her collapse. She’d been fine in the morning, jumping in the truck to take a green waste load, then collapsing on the walkway less than an hour later. Freaked, I rushed her to the vet as we tried to figure out what was going on (tox screen negative, no blood in the fluid in her belly). My vet did not like the look of her liver on the initial ultrasound, so did a more thorough one to email to a specialist for review. I picked her up & we spent the night at friends near the designated emergency vet during the planned PG&E power outage. Overnight I slept on the floor next to her; the vet called late & said the specialist said her liver was full of tumors seen on the ultrasound. She passed before I could get her to the emergency vet on a Sunday…at least she was surrounded by love. I had NO clue what I’d missed, what I could have done. I was a mess. I’d just received, but had not read the Nov issue of WDJ, but a couple of days later the online article came to me. I was gobsmacked by reading this account & all the comments; it just rang true. I shared all this with my vet—I chose to bury Scout rather than do any further physical investigation….just couldn’t handle that. So, yes, I think this awful disease is just what she passed from. She was bright, lively, and happy right up to the day she collapsed. I am grateful she didn’t suffer any longer & would have taken steps to relieve even those hours of pain if I’d known there was, really, no hope at all. The house is way, way too quiet.

  8. My Australian Shepgherd female died of Hemangioscarcoma at 10 as well. I raised her on a raw diet. She also received Apoquel and then Cytopoint. I had discontinued the Apoquel but she got it on and off for 6 months. Allergist recommended Cytopoint for allergies, or what seemed like allergies.. – two injections, 6 months apart. the last one 4 to 5 months before she died. I wonder too if either the Apoquel or the Cytopoint changed her cells. She had 8cm tumor on her spleen that leaked then burst. She had the surgery, no metastasis at time of surgery that they could see. Had everything checked. I saw evidence of metastasis 10 days later (little collapses) even though she was recovering beautifully from the surgery. . Oncologist gave bad advice, sent her off a cliff. She recovered then I had to put her down because she was clearly bleeding again. Discovered that day she had metastasized to her liver and abdomen. Didn’t even get a chance to start her on Yunan Bayao and Aminocaproic acid. Broke my heart.

  9. I´m reading this article almost a year and a half after my 10 year old Husky-Shepherd mix died of hemangiosarcoma. I had taken her to the vet a month before because of intermittent lethargy, and what appeared to be abdominal swelling that would come and go. He treated her for anemia. A month later, I returned home to find her splayed on the floor in the bathroom and breathing with difficulty. I rushed her to the vet and they took her back to examine her. When he came out to the waiting room to talk to me, he told me my two options were surgery or let her go. What an awful place to be! I could not put her through the surgery knowing that her chances of survival were so low. I was able to be with her. She did not suffer and went peacefully. I still have trouble with the loss, and that I had no time to prepare myself. Still, I feel as if I made the best decision for her. She was a wonderful friend for 10 years.

  10. Cisco my American Bulldog suffered this same cruel fate. After diagnosis, and research as to what extra time surgery would buy him, I made the call to a vet that would come to my home and set him free. He was so sweet those last few hours, but ready to go. surveying his yard , eyes at half lid…I laid beside him and pet my best friend. When the vet arrived, he greeted her with his typical friendly wag, but wearily. She was so compassionate…but said she could tell he was so very ready to go. He went so peacefully, on his blanket under the tree in the backyard, and god smiled upon us by giving us a beautiful spring day. I miss him so much.

  11. I came back to revisit my post in late Oct ‘19 & re-read earlier posts & more recent ones. I share all your pain and loss….the suddenness of this disease, almost no warning and hard decisions of letting our dogger-family go is so, so hard. My girl, Scout, a PWD passed at my friend’s house after I’d gone to the emergency vet to arrange to bring her in to ‘let her go’ and then to my house to let my wonderful neighbors know where to dig the grave under the willow tree (I’d made a call for help in digging her grave). Scout passed, on her own at my friend’s house, while I was on this mission—only gone a short while, but my friends thought she may have waited until I left to pass. When we brought her home for the final time, my friends helped transport her, my neighbors had dug her grave in the appointed spot and had a tub full of lavender, sage and rose blossoms to bury her with. She rests next to my Dal, Sadie, who rests next to my Gordon Setter, Meg, in my garden. I have a chair and little table and have tea with them often and savor great memories of times past. The hemangiosarcoma was the least warning I’d ever had—less than 24 hours!—for a dogger passing, so was especially traumatic for me. I am so glad, in retrospect, that I didn’t try for heroic measures (surgery, etc.) given the near 100% fatal prognosis of visceral hemangiosarcoma—even tho’ less than 24 hours of suffering was too, too much. Glad she chose to exit on her own, but would have spared her even that if I’d known more earlier. At least, for me, laying next to her all night, was my long goodbye to her as it became apparent that she was ready to let go of this life. I miss her Every. Single. Day.

  12. Today 3.40am my best friend my boy Spirit, the happy energetic talkative beautiful boy ,also lost his life to Hemangiosarcoma within a week of his opperation to remove his spleen.
    Spirit, was a 9 year old a Siberian husky always full of life like a puppy. HOW does a healthy boy, just die in our arms this morning at home.
    My heart is broken in billions of pieces and what’s left is trying to find answers to justify my choices,. Is there anything at all different we could have done?
    Did I make the right decisions, did I hear the Vet right or was I too emotional to take it in.
    When we took Spirit in he was weak, there were hardly signs anything but a virus as there was 1 going around last week and we through he was just a little lethargic from that, increased panting, but this guy was a fluff ball and we were used to that. Gone off his food a bit, yes but huskies well this husky did ,but he always lived what you had💗
    Upon our consult the vet simply told us “Spirit is a very sick boy he has a “mass” in his tummy and we need to get a ultra sound quickly”.. shocked and floored we quickly agreed and the surgery was done on the Saturday morning.
    The vet called us and told us the news Saturday afternoon..
    He had a mass on his spleen and it didnt look good tests .. our hearts sunk ,he didnt seem that sick at all!
    Next day we went in the vet said he has “Hemangiosarcoma” and his spleen was removed but unfortunately it has spread small dots all over his liver.. Hema WHAT??… (visiting him) We picked up our boy 4 days later ,he was awful in pain plus separation anxiety, my hubby and brought him home quickly remove the (cone) off his head and my boy seemed to be alot happier again.
    He ate small bits that night and was restless but we expected it will take time.
    That night and next morning he was not well, pacing.. irratable couldnt settle,breathing laboured wobbly on the legs no appitite,
    HOW COULD HE BE WORSE?
    We took him back and there was a type of “fluid” around his tummy.. we took him back home with hopes that the anti nausea injection would help and then he may eat, get his strength up a bit and reevaluate this “fluid” the next day with the vet..

    He never made it,

    tears are pouring down my face as I write this, what could I have done differenlty?
    He always slept beside me on his blankets, my best friend..motionless and staring into nothing extremely laboured breathing … thinking he would be happier on the bed we wanted to keep him between us but he suffered a massive heatattack that I will never forget, as we lifted him and died in a second in our arms..
    Taken from us in a single moment.
    This forum has helped me see that iam not the only one who is left in shock looking for answers..
    And my heart is like so many of you that just didn’t expect this cruel diseases to take our babies away so viciously with no hope and no time to even think..
    Just gone ,
    when 2 weeks ago he was crazy running around the park happy with years and years to live being smiling at me and loving life just gone in days.
    my happy boy , my everything.

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