Chapter Thirteen – The Learning

Things seemed to be getting better, particularly through the holidays.

Anya, Asa, Asmara and even Ardin came for a visit. I had lots of playtime and people food! Sara scolded everyone one evening in the dining room for their generosity toward me. “Hey, Luke’s going to get really fat if you people keep giving him table scraps on the sly!” This in the middle of a scrumptious bite of turkey and Russian dressing that Asa had kindly slipped me in the kitchen. Of course, that was after the gravy that Anya had poured over my evening meal. I had almost made a clean getaway with it all when Sara stopped Asmara from handing me a buttered roll as he walked by my dish. Awww! I could smell the golden butter; almost had it on the tip of my tongue.

New Year’s came and went. Everything gradually settled back into our normal routine of daily walks and going to the office.

Fourteen evening meals after Ashlundt’s family left, my stomach started telling me that maybe I overdid it. I went to bed one night feeling overstuffed and nauseous. The next morning I had a hard time getting out of bed, even after a full night of sleep. The pain in my stomach wouldn’t leave me. I pushed through the day but had little appetite that night. This was hardly like me to not want to eat at mealtime. I was totally confused. Maybe I was still stuffed from the extra food I’d been treated to by the family, I guessed.

Ash, did you notice that Luke left most of his dinner?” Sara rubbed my somewhat rounder belly as we sat on the sofa in the den together.

He’s probably spoiled from all those good holiday meals, Sara.” Ashlundt laughed and reached over to pat me on my thigh.

No, no, it’s been too long for that. Hope he’s okay. It’s not like him to leave his food.” She moved closer to me and put my head in her lap. Even though my stomach still ached, I closed my eyes and sighed at her loving touch on my head.

Ashlundt immediately sensed that I was hurting the next morning when he got out of bed. I heard him wake Sara. “Something’s wrong. Look at Luke’s face – he’s in a lot of pain.”

I felt Ashlundt kneel down next to me. “His stomach… it’s tense and sensitive to my touch. Let get him over to Suzi at the clinic right now.”

I felt his strong arms lift me from my bed, and I whimpered a thank you. The extreme pressure of the pain was becoming unbearable. I felt like I was going to burst.

Sara was on her cell phone calling the vet. “Suzi, are you at the clinic yet? No? Can you meet us there? It’s Luke. He’s in a lot of pain. We think it’s his stomach.”

I was ushered into the old familiar clinic with its Pine Soil smell and slick tile floors and to the back where I heard Suzi’s reassuring voice. “It’s okay, boy. We’re gonna take some x-rays and blood tests. Probably do a sonogram too.”

The tests themselves weren’t too terrible. The vet took my temperature and felt around all over me. I could feel her listening to my heart. Plus, Suzi had given me some medicine that kicked in just before the sonogram. I started to feel a little less pressure inside. After the tests, Ashlundt and Sara sat with me on the floor and kept their hands on me as we all waited. Soon, I heard the vet’s familiar voice.

Sara. Ash. Here’s what I know so far. There’s something weird going on with his liver. I want him to have some more tests to pin it down. If that’s all right with you both?”

Absolutely,” Ashlundt stated firmly. “Do whatever you have to so we can get him feeling better.”

He’s stable enough right now. I’ll need you to take his x-rays and drive him up to Ventura to the Veterinary Surgical Group. It’s an acute care hospital with the latest, most advanced diagnostic equipment. I’ll call ahead to Dr. Vandersloan.”

Thank you,” Sara uttered softly. “We’ll run there right now.”

The ride took some time, but I was in less pain than I had been earlier. I was able to nap on my cushion in the back of the SUV. Sara had thoughtfully brought my stuffed bear, and I used him as a pillow.

This new clinic had a funny smell. It reminded me of the day we unpacked Ashlundt’s new laptop computer from its box. Sort of like a new-technology smell. There were lots of noises inside the clinic – beeping devices and metallic sounds - that drove me crazy at first but slowly faded into the background as we waited to be seen.

Ashlundt and Sara spent the rest of the day waiting and consulting with the doctors while I went through a battery of tests. I was poked and pinched. Something they gave me made me sleepy. I felt tubes being run up my rear end, and people’s voices buzzing around me, but it was hard to pay attention to what they were saying. I was in such a strange haze.

After what seemed a long time, Dr. Vandersloan, the one who had been testing me, brought me into a room with my humans and broke the terrible news.

I’m sorry, but it appears to be Hemangiosarcoma... an aggressive form of cancer in dogs. It's present in both his spleen and liver.”

They had immediately started to rub on me when I entered the room. With the news, I felt my humans’ four hands jolt from my back in surprise, then immediately return to try and comfort me.

The abdominal pain that you first saw this morning was caused by internal bleeding.” He stepped forward and patted me on my head. “The bleeding stopped on its own accord, and Luke's condition has stabilized. He’s actually continued to improve today. He’s doing pretty well right now.” I heard him step away from me. “You can take him for a short walk if you’d like. He seems to be in good spirits. I think after such a long day he probably just needs some time with you both.”

I had no idea what this could mean for me. Sara took me out for a short walk, while Ashlundt hung back with the vet to talk further. I was so happy to be outside, to breathe in some fresh air after a day of being poked at by doctors. Sara was quiet. But no matter, I was just hoping that Ashlundt could finish his business inside so that we could all jump into our car and go home. I felt sore in all the places they had violated. I longed for my leather sofa with the TV blasting and the voices of my humans laughing together. Instead, when Ashlundt joined her, they were quiet and somber, and I could hear Sara sniffing.

Don’t cry, Sara. We’ll get through this. Luke will get through this,” he softly comforted her.

Soon, we stopped in a sweet-smelling grassy area, and they dropped down next to me. Sara started petting my back in a soothing gesture. “My sweet boy, how can this be?”

Ashlundt scratched my ears. “Sara, the vet says that this kind of cancer can cause severe internal bleeding at any time without warning. He wants us to leave Luke with them overnight.”

NO!” Her voice was filled with alarm.

Sara, listen to me. They can keep a close eye on him and pump him full of fluids to replace the blood he’s lost.” I felt his hand on my head. “ If he remains stable overnight and there's no more tests to be done, we should be able to take him home sometime tomorrow morning.”

I tensed up at the news. In all my days since I was a puppy, I couldn’t recall a single night when I slept anywhere other than home, or at the Bensons.

Oh, Ash, I don’t want to leave him all alone here!” Sara cried.

He won’t be alone, honey. He’ll be well cared for.” His hand left my head, and I could hear him rubbing her leather jacket. “If he starts to bleed in the middle of the night, we won’t be able to help him quickly enough. Just trust the vets here, okay?”

But, they’re strangers. Can’t we stay with him, Ash?” She was pleading.

We’d just have to sit in the waiting room all night, Sara. If you want to do that, we can.” He sounded committed to whatever would ease her distress.

But he won’t know where we are!”

Would you feel better if we just get a hotel room close by and come back early to see him in the morning?”

Y…Yes, please.” She blew her nose and sniffled.

I felt the warmth of their hands on my back, but I was afraid for myself for the first time in my life. I didn’t want to be separated from them. We had all just truly been reunited, and now this. I didn’t know what this meant to our harmony. I dreaded that Ashlundt would reject me again.

They reluctantly left me. A kind woman that the doctor called Amy took me somewhere in the back. She led me to a holding container that had a soft pad, blanket and my Teddy Bear that Sara left for me. A bowl of water was at the front of the container. I was so thirsty and lapped down the water only to vomit it up minutes later.

Poor, baby,” Amy’s voice soothed. Then I heard her call out, “Dr. Vandersloan, Luke just threw up his water; do you want him on an IV tonight?”

Soon I felt the container door open, and Amy’s voice was comforting. “Here, Luke, I’m just going to stick this into the catheter in your leg; won’t hurt. Good boy.”

The door soon shut, and I lay there feeling hungry and wondering when they would feed me. I listened to the sounds of metal and the voices of the humans. A strange smell offended my sensitive nose, and my stomach growled as I drifted off to sleep for awhile. I tossed and turned most of the time, and my stomach began to hurt again.

They came for me the next morning as promised. Dr. Vandersloan brought me out to a carpeted waiting room. I was overjoyed to smell my humans who immediately hugged me warmly.

Oh, Lukey boy, we really missed you!” Sara exclaimed while scratching behind my ears.

The night just wasn’t the same without you, boy,” Ashlundt whispered, before kissing me on the forehead.

Our happy reunion was harshly interrupted with some more bad news.

Dr. and Mrs. Jaynes, if I could have your focus for just a moment?” Dr. Vandersloan’s tone was stern.

Ashlundt stood up quickly. Sara stayed down in her crouch with me on the floor.

The vet’s authoritative voice filled the room. “We just reviewed his CAT scan that we took on Friday. It reveals that no tumors can be seen in other parts of Luke’s body. This indicates that the immediate problem is isolated to just his spleen and liver.”

Is that good news?” Ashlundt questioned.

In some cases, yes, but the real concern here is that Luke continues to bleed out. There’s a suspicious mass on his liver. We’d like to do surgery on Sunday morning to remove the spleen and that mass from his liver. The surgery is his best short-term option.” The vet’s tone was terribly serious.

What do you mean?” Sara sounded worried and confused.

Well, there’s a slim chance that the tumor is not malignant. It may be just a benign hematoma.” I heard him tap his pen on something metal. I assumed it was one of those medical clipboards vets used. “I once removed a 12-pound hematoma from a dog that went on to make a full recovery. But, anyhow, there's no way to know for sure what the tumor really is without removing the suspect tissue and sending it to a lab for analysis.”

There’s hope?” Ashlundt’s voice sounded strangled by anguish.

There’s always hope, Dr. Jaynes,” the vet replied. “To improve Luke’s odds of coming through the surgery, we’re going to type and match donor blood for him. Having several units of fresh blood immediately available will improve his chances.”

Coming through the surgery?” Sara’s voice was almost hysterical. “Do you mean it might kill him?”

The vet moved closer to her. “There’s always risk with any surgery. But without it, he won’t make it.”

Why can’t you do the surgery today?” The urgency in Ashlundt’s voice was unmistakable.

I’m sorry, Dr. Jaynes. We already have back-to-back surgeries scheduled this afternoon. I can’t get to him until tomorrow morning. Also, we need time to get the fresh donor blood.”

I was allowed another walk with my loved ones. I could hear the sadness in their breathing and sullen tones of voice.

If it’s cancer, I don’t understand how he could have gotten it, Sara,” Ashlundt declared. “We’ve always taken the best care of him; the best food. I don’t know if it could be environmental to our area? First Bear, then you, and now Luke.”

I felt exhausted after only a few steps. Maybe that restless night in the clinic had sapped me of my energy. I decided to lie down in the grass alongside the parking lot.

Let’s get him back inside, Ash; he looks worn out,” Sara ordered.

Suddenly I felt Ashlundt’s arms embrace me. He lifted me to his chest and buried his face in my neck, just as he always had with Sara. And then relief washed over me. I heard the simple words that made all the difference to me.

I’m here for you, my friend.”

I didn’t remember much after that. I heard the vet say that I’d been resting comfortably and snoring a lot. I napped often. Time had no meaning for me. I was on what they called “IV fluids” and couldn’t measure the passage of time without my evening meals. I remember someone checking on me and speaking to me in a kind voice. “Hey there, big guy. Just gonna fix this here for you.” They did something with the IV bag. Later, I recall being rolled along, then going to sleep.

When I awoke, I was okay for a moment. My head felt hazy, but I was sure that I was alert. Then, the soreness kicked in. I felt a muffled burning sensation right in the center of my belly. I heard a woman’s voice talking to me. “You’re doing well, boy. We hope you can go home Wednesday or Thursday.”

I drifted in and out, wondering what had happened. I had no sense of passage of time. And there was no daylight or nighttime inside the clinic. Not that I’d have been able to tell the difference since I’d lost my eyesight.

Eventually, I awoke feeling quite hungry. One of the doctors gave me a small portion of soft meat that smelled like lamb and rice. I gobbled it down and hoped for more. I heard the familiar vet’s voice telling another man, “His long-term prognosis is still not good if the tumors are indeed cancerous.”

Ashlundt and Sara finally came for me.

Lukey, how are you sweetie?” Sara’s voice was full of concern.

Hiya, boy. How’re they treating you here?” Ashlundt’s tone seemed to be playful, although I suspected that this was his way of coping with the seriousness of the situation. I still didn’t know how long I’d been away from them, but I was overjoyed by their presence. I expressed my joy with pathetic barks that seemed to be muffled. I felt so embarrassed by my inability to be myself. And my belly still burned pretty badly. I wanted to reach down and scratch the sore spot, but it was covered with a big bandage. Even more concerning, someone put a harness around my neck and chest that prevented me from being able to get to my sore spot. I was only able to sit at the counter next to them and listen to them talk to the vet again.

With chemo, we can expect him to be with us for about six to twelve months before the cancer returns. If the tumors are not cancer at all, then he’ll make a full recovery. We'll know more when the lab results come back.”

I just couldn’t wait to get out of there. Once Ashlundt opened my door for me, I tried to leap into the car but the things they called staples pulled at my stomach. They stopped me dead in my tracks. Even though the pressure from before was gone, the burning pain left my belly on fire.

Easy, boy,” Ashlundt warned. “You’re getting better, but don’t push it.”

On the way home, my humans talked about waiting for lab results and throwing around many words that I didn’t understand, like “homeopathic.”

I asked the surgeon if he could tell during the surgery whether or not it’s malignant,” Ashlundt spoke from behind the wheel. “He said he really couldn’t tell just from looking at it.”

The assistant said it would probably be Monday before we get the lab report.” Sara was sitting in the passenger’s seat, right in front of me. “They know more about these things.”

It was so exciting to be back home. Of course, my excitement was muted by the fire in my abdomen. All the familiar terrain - the carpet, the smells, the rooms and my bed – was heaven to me. During my first walk outside with Sara, I sufficiently marked every leaf and flower in my front yard. It was fun, but also exhausting. Soon thereafter, I headed inside for the leather couch in the den and a long nap. Life was once again good.

It was good, that is, until the afternoon following four evening meals later. I was resting on my special bed in Ashlundt’s clinic office when he punched in on his speaker phone.

Dr. Vandersloan on line one for you, Ash,” his receptionist stated.

This friendly voice was followed by a familiar, yet somber voice.

I have some bad news, Dr. Jaynes. The tumors that were removed from Luke are definitely Hemangiosarcoma. It looks like he's going to have an uphill battle.”

I could hear Ashlundt take in a sharp breath. “How long does he have?”

Six months… maybe more if we do chemotherapy. But the prognosis isn’t great. I know this must all be really painful to deal with, but…” His voice went silent.

Okay, I’ll speak to you after I’ve discussed it with Sara,” Ashlundt replied. “Thank you for all you’ve done for us.”

Ashlundt said nothing for a few minutes. I could hear him breathing heavily. I heard him stand up and felt him grasp my collar and gently guide me down the hall. I knew from the number of steps and the direction that this was Sara’s office. I heard him shut the door. I walked to my bed and snuggled down into it. He didn’t walk away from me this time.

It’s bad, Sara. He has cancer. We have to decide whether to do the chemo or not.”

I heard a sob from her, and then I knew that he had buried his head in her neck because his voice was muffled. “Oh, God, Sara, this could have been you. I’m such a stupid fool!”

Why, Ash?”

I wasted so much time punishing you and Luke for something that neither of you could have helped.” His voice was filled with pain.

Ash, you’ve been letting go and forgiving; you’ve made so much progress.” Sara’s tone was reassuring. “Don’t put this on yourself.” I heard her chair creak from his weight pushing on her. “It’s just life, and we have to give Luke every chance that we can! You are standing by him now. We’ll do the chemo and buy Luke more time. We’ll make it the best few months of his life.”

We’ll do more than that, Sara.” His voice grew stoic. “I’m going to look for other alternatives as well.”

The love that I felt in that room at that moment made me forget anything that happened in the past. I wagged my tail and rolled over in my bed to show them my appreciation. They both dropped down to the floor and put their heads close to me, and I covered their faces with kisses.

********

Recovery from the surgery wasn’t easy. But soon, my energy returned, as did my appetite and playfulness.

Thankfully for me, chemotherapy has less radical effects on dogs than it does on humans. Sara or Ashlundt would take me to the clinic in Ventura for what they called “single-agent doxorubicin,” intravenously given every 3 weeks. The vet used a needle connected by a tube that was wrapped in a bandage. I would feel the occasional nausea, and was a bit sluggish after each session, but otherwise I was almost my old self again. At first, I wanted to lick at the wrap that covered my leg, but Sara and Ashlundt explained that I should “leave it.” So, I eventually did, with a little bit of snack bribery.

Ashlundt found one piece of encouraging news on the Internet and called Sara into his office to explain it to her. “There’s an experimental treatment called apSTAR.” He pulled her over to his computer and read to her: “It’s the use of a laser combined with a polymer. Experiments have shown improved rate of primary and metastatic tumor regression in laboratory models of tumors.”

Ash, do you want to try something experimental on Luke?” I visualized that she was standing in front of him with her hands on her hips when she questioned his judgment. “What if it’s dangerous?”

Don’t worry. I’ll call Dr. Vandersloan; find out more about it.”

Ash, I’m so proud of your efforts to help our boy. Thank you.” I heard her give him a big smooch, then leave his office. She stopped to give me a huge hug on her way out.

Luckily for me, he put the call on speaker phone as he dialed the vet’s office. Ash got through to him on the first try, “Wow, Dr. Vandersloan, I didn’t expect to get you this quickly.” He proceeded to ask about the experimental treatment.

Ash, Autologous Patient Specific Tumor Antigen Response is an immune activating laser procedure. It’s been shown to induce long-term tumor immunity and increase the rate of primary and metastatic tumor regression. It’s a personalized approach to fighting cancer.”

Is Luke a candidate?” I heard him tap his foot nervously on the floor. “My research shows it increases life expectancy and possibly even cures the cancer.”

Unfortunately, no. The procedure was developed, in part, at Oklahoma State University and is now entering field evaluation on a limited basis. But, so far it’s only worked on surface tumors and not on animals with Luke’s particular form of this cancer.”

Uh, okay. So, this won’t work for Luke.” Ashlundt’s voice was dejected.

No, Ash, not this one. I promise you, if I had any possible experimental procedures, I’d recommend them for Luke.”

Ashlundt quietly thanked the vet and clicked off the speaker phone. I stretched and walked over to him and thoroughly washed his hands.

It’s okay, boy. The chemo’s going to work anyway.”

Ashlundt persisted in his search for an experimental cure for me, and I was grateful, even if I didn’t understand all the medical terms, or the severity of my illness.

******

A few weeks later I was feeling very good. We had gone for a ride in the car, just for me, and I really loved it. Ashlundt even rolled down the window and let the cool breeze blow through my fur. I had eaten my evening meals like I was starving for several days running. And instead of listening to his conversations with the vet, I would take a nice nap next to him in his home office. Apparently, I must have developed a loud snoring habit because Ashlundt would sometimes nudge me with his foot. “Luke, shhh, I can’t hear what the vet’s saying.”

I drifted off again and awoke to the end of a discussion he was having with Sara. “Sorry, baby. He’s not a candidate for anything experimental that I’ve found so far.”

Ash, we just have to keep faith with the chemo at this point.”

Again, I could feel the closeness between the two of them. Ashlundt brought me out of my relaxed state with a tempting offer. “Wanna play bell ball, boy?” I was out the doggie door to the back yard in a flash.

My illness and the fear of losing Sara seemed to be the jolt that Ashlundt needed to come to grips with what both she and his therapist had tried to teach him. His entire demeanor was changing. There was gentleness about him that had rarely been present before. His new approach to living gave me such a sense of greater purpose for my own life. I had helped them get through some of the worst times of their lives, and I knew that was why I was sent to them.