By now, most of you know JP, my 12-year-old rescue pit bull, cancer survivor extraordinaire. JP is the first dog that I’ve ever owned as a responsible adult. Not only is he the main character in my book It’s a Dog’s Life… but It’s Your Carpet, but he’s been my main squeeze for the past decade plus.
 

JP has been my loyal companion and "Justine-supporter" through many a move, transition, job, residency, and boyfriend. JP is named after Jamaica Plain, an up-and-coming (i.e., ghetto) subdivision of Boston where I used to live. (This is on the infamous "other" side of the tracks, where one needs a pit bull to safely walk down the street.) Since rescuing him from parvovirus, he’s been a fantastic, well behaved, obedient ambassador for the breed.

One year ago today, JP acutely seizured. As an emergency critical care veterinary specialist, I knew instantly what this meant — something horrible: a stroke, a hypertensive event, or a brain tumor. Unfortunately, a few days later, JP was diagnosed with an aggressive brain tumor (a suspected glioma) based on the MRI.

Panic set in. This dog was my main love: above boyfriends, family, and friends. The rational, scientific side of Justine fought with the emotionally charged, "pathologically-attached-to-my-dog" Justine. I frantically called fellow colleagues who specialized in veterinary oncology or neurology to figure out what to do. My options…

Euthanasia - Humanely euthanizing him
Average life span: 0
Cost: $200-$400
Pros: He doesn’t suffer; no seizures or behavioral changes to deal with
Cons: He’s dead, I’m a mess, and I’ve had no time to spend with him

Medical management - Putting him on anti-seizure medications and steroids (to reduce the swelling in his brain)
Average life span: 1-2 months
Cost: $200-$400
Pros: Cheap
Cons: I’m still dealing with bad seizures; I have to deal with side effects from the medication (e.g., excessive thirst, urination and hunger); and I don’t get that much more time with him

Traditional radiation therapy +/- chemotherapy - Putting him under anesthesia once a day for 21 days for radiation therapy to zap his whole brain (including healthy brain tissue)
Average life span: a few months
Cost: A few thou’ ($3-$4,000)
Pros: I can get it done locally in St. Paul, MN
Cons: High risks of anesthesia, low specificity of radiation

Stereotactic radiation therapy (SRT) - Putting him under anesthesia once a day for 1-4 days for a specialized radiation therapy that zaps only his tumor — not his whole brain. Average life span: 4-10 months
Cost: $8000-$10,000
Pros: Cutting edge technology where it’ll maximize a good quality of life; specific localized radiation against evil tumor cells
Cons: High risk of anesthesia; expensive — it costs more than my car; and I’d have to drive cross-country for it (as it’s only offered in a few places in the United States)

Brain surgery - Putting him under anesthesia and having the tumor surgically "debulked" (which is a nice way of saying "melon-scooped" out, as an anonymous veterinary oncologist told me).
Cost: Free, thanks to an NIH grant at University of Minnesota
Pros: Cutting edge research; free; done by board-certified specialists
Cons: High risk of anesthesia; risk of having a mentally-impaired dog post-operatively

So what did I do?

I needed to do everything that I could, as long as it didn’t hurt JP or put him through what I deemed to be too much. I wanted my dog — not a mentally impaired dog — and couldn’t handle the risks of JP losing his cognitive function or personality.

So, thanks to a 5-hour energy drink and a mocha, I drove non-stop from St. Paul, MN to Fort Collins, CO to one of the top oncology departments in the world at Colorado State University for stereotactic radiation therapy. Thanks to the support of some excellent counseling staff at Argus Institute (part of Animal Cancer Center’s team), I was able to survive the tumultuous, stressful, one week experience…
 
A few weeks later, once JP was recovered, a friend asked me, "What’s the cost-benefit ratio to you?" In other words, how long would JP have to live before it was worth the financial investment for SRT?? Bluntly, I said that if I got an extra six months with JP, I’d be happy. I needed that time with JP to say goodbye, provided it was a good quality life.

One year later today, I crunched the numbers. Between his MRI, CT, blood work, SRT, medications, pet-sitting and dog walking fees, treats, emergency endoscopy (Damn rawhide!), etc., JP cost me $37/day since his initial seizure one year ago.

And you know what? It was worth it.

While my friends and family were appalled by what I spent on JP, I needed it. (This coming from the girl who is too cheap to splurge on Starbucks mochas more than once a week.) All in all, I’m ecstatic that I had an extra 365 days to spend with JP. My love for that mutt runs deep, and I’m blessed that I was able to afford it.

I’m cognizant that most people aren’t, but where people splurge on cars, plasma screen TVs, and assorted materialistic things, I splurge on pets. (I do drive a 2000 Hyundai, after all). Besides which, $37/day is a hell of a lot cheaper than a daily shrink visit … and JP has provided me a lot of mental health.

JP is on his last leg, and I’m battling the decision to humanely euthanize him as we speak. I’m not even sure if he’ll be alive by the time this blog posts. Regardless, JP would appreciate the dedication in The Daily Vet.

To all those pet owners out there struggling with cancer: Hang in there. Whatever decision you make is the right one.

To JP: Thank you for teaching me more than I could ever learn from a two-legged human — devotion, loyalty, companionship, and most importantly, that success isn’t measured by society, but by the joy of a tail wag.

Dr. Justine Lee

Pic of the day: JP by Me

JP (the dog) and Justine Lee, a vet and her dog, for the love of dog, dog with cancer, pets with cancer, loss of pet, pet death, losing a pet, caring for dogs with cancer, pit bull mix, woman with dog